Researchers Find Hospitals Failing at Monitoring Source of Hospital-acquired Infections

Urinary tract infections are the single most common hospital-acquired infection in the United States. If you have ever a urinary catheter, which one-quarter of all patients do, a new nationwide study conducted by the University of Michigan may stun you - the majority of hospitals do not have a system in place to control their use or safety. This despite that the health care industry knows that 1 in 100 hospital patients acquire a urinary tract infection while in the hospital, many of which lead to life-threatening complications.

The group of researchers associated with the University of Michigan Veteran's Administration Hospital sent out surveys to 600 private hospitals with more than 50 beds and maintain intensive care units, and to all 119 Veteran's Administration hospitals, with a 72% response rate from the hospitals' infection control coordinators.

The results could at best be called startling.

Less than half of the hospitals monitor which patients have urinary tract catheters, and nearly three-quarters of all hospitals do not monitor how long a urinary tact catheter has been in place. Nearly the same number of private hospitals (71%) do not use portable monitoring systems to check on the urinary tract health of the patients with catheters.

"Until now, we haven't had national data to tell us what hospitals are doing to prevent this common and costly patient-safety problem," said lead author Sanjay Saint, M.D., MPH in a press release from UM. Saint is the director of the U-M/VA Patient Safety Enhancement Program, and leader of several other studies on catheter-related issues. "Now that we have these data, it's clear that there's no one dominant practice that's being used, including physician reminders, which have proven benefit and make a lot of common sense," Saint said.

The good news for veterans was that VA hospitals were nearly twice as likely to have systems in place than private hospitals to prevent urinary tract infections caused by catheters from starting in the first place, by using tactics known to help limit the spread of the infections.

The survey asked a series of questions, including what types of catheters were being used, to how patient progress was being monitored by physicians and staff.

Saint said "The bottom line for hospitalized patients and their families is, if you have a catheter, ask the doctor or nurse every day if you really still need it."

The study's other authors are Sarah Krein, Ph.D., R.N., a research assistant professor of internal medicine and research investigator at the Ann Arbor VA, Christine Kowalski, Samuel Kaufman, Timothy Hofer, Carol Kauffman, Russell Olmstead, Jane Forman, Jane Banaszak-Holl, and Laura Damschroder. The study was funded by the Department of Veterans Affairs, and the U-M/VA Patient Safety Enhancement Program.

The full study appears in the January 3, 2008 edition of the journal Clinical Infectious Diseases.