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Clin Infect Dis. 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236. Epub 2015 Mar 26.

Enhancing Resident Safety by Preventing Healthcare-Associated Infection: A National Initiative to Reduce Catheter-Associated Urinary Tract Infections in Nursing Homes.

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Geriatric Research Education and Clinical Center, Veteran Affairs Ann Arbor Healthcare System Division of Geriatric and Palliative Care Medicine.
Division of General Medicine Department of Internal Medicine, Department of Pediatrics and Communicable Diseases, Division of General Pediatrics, University of Michigan Medical School, Ann Arbor.
Health Research & Educational Trust, Chicago, Illinois.
Division of Geriatric and Palliative Care Medicine.
The Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center Section of Infectious Diseases, Departments of Medicine and Surgery, Baylor College of Medicine, Houston, Texas.
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of General Medicine Center for Clinical Management Research.
Division of General Medicine Center for Clinical Management Research Medicine Service, Veteran Affairs Ann Arbor Healthcare System, Michigan.


Preventing healthcare-associated infection (HAI) is a key contributor to enhancing resident safety in nursing homes. In 2013, the U.S. Department of Health and Human Services approved a plan to enhance resident safety by reducing HAIs in nursing homes, with particular emphasis on reducing indwelling catheter use and catheter-associated urinary tract infection (CAUTI). Lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent CAUTI in over 950 acute care hospitals called "On the CUSP: STOP CAUTI" will now be implemented in nearly 500 nursing homes in all 50 states through a project funded by the Agency for Healthcare Research and Quality (AHRQ). This "AHRQ Safety Program in Long-Term Care: HAIs/CAUTI" will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship as well as promoting patient safety culture, team building, and leadership engagement. We anticipate that an approach integrating technical and socio-adaptive principles will serve as a model for future initiatives to reduce other infections, multidrug resistant organisms, and noninfectious adverse events among nursing home residents.


CAUTIs; nursing homes; patient safety; post-acute care facilities

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