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Infect Control Hosp Epidemiol. 2008 Apr;29(4):333-41. doi: 10.1086/529589.

A multicenter qualitative study on preventing hospital-acquired urinary tract infection in US hospitals.

Author information

  • 1Veterans Affairs Ann Arbor Healthcare System, the Veterans Affairs Medical Center/University of Michigan Patient Safety Enhancement Program Ann Arbor, Michigan, USA. saint@med.umich.edu

Abstract

OBJECTIVE:

Although urinary tract infection (UTI) is the most common hospital-acquired infection, there is little information about why hospitals use or do not use a range of available preventive practices. We thus conducted a multicenter study to understand better how US hospitals approach the prevention of hospital-acquired UTI.

METHODS:

This research is part of a larger study employing both quantitative and qualitative methods. The qualitative phase consisted of 38 semistructured phone interviews with key personnel at 14 purposefully sampled US hospitals and 39 in-person interviews at 5 of those 14 hospitals, to identify recurrent and unifying themes that characterize how hospitals have addressed hospital-acquired UTI.

RESULTS:

Four recurrent themes emerged from our study data. First, although preventing hospital-acquired UTI was a low priority for most hospitals, there was substantial recognition of the value of early removal of a urinary catheter for patients. Second, those hospitals that made UTI prevention a high priority also focused on noninfectious complications and had committed advocates, or "champions," who facilitated prevention activities. Third, hospital-specific pilot studies were important in deciding whether or not to use devices such as antimicrobial-impregnated catheters. Finally, external forces, such as public reporting, influenced UTI surveillance and infection prevention activities.

CONCLUSIONS:

Clinicians and policy makers can use our findings to develop initiatives that, for example, use a champion to promote the removal of unnecessary urinary catheters or exploit external forces, such public reporting, to enhance patient safety.

PMID:
18462146
[PubMed - indexed for MEDLINE]
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