Tuesday, March 15, 2016

Finally! Device Utilization Ratios and Catheter Associated Urinary Tract Infections

Finally a publication that argues for the use of urinary catheter device utilization ratios as a an outcome and not a mere process measure. 

Fact: urinary catheters are overused and cause harm.

Over the last 18 months we have begun to aggressively assess, track and feedback urinary catheter device utilization ratios. Through education and feedback of urinary catheter daily need documentation in the electronic medical record, we have seen a persistent downward trend in catheter use. Like catheter associated urinary tract infections (CAUTIs), documentation of daily catheter need along with device utilization is a standing report at the hospitals's infection control committee and is fed back to unit and hospital leadership. The outcomes of interest are both catheter use and CAUTIs.

The result? Increasing review of daily catheter need, decreased catheter use and decreased CAUTIs.

Today our automated, electronic discontinuation orders for urinary catheter discontinuation goes live. This mechanism will require a formal override of catheter discontinuation if ongoing use is desired, further minimizing unnecessary catheter use. The evidence to support this is neatly summarized here.