Veterans Administration Nursing Homes Implement Robust Surveillance of Urinary Tract Infections

An AHRQ-funded study found that catheter-associated urinary tract infection (CAUTI) surveillance practices within Veterans Administration (VA) nursing homes were more robust than those at non-VA nursing homes. Researchers who surveyed 47 VA and 306 non-VA facilities in 41 states found that 94 percent of VA nursing homes conduct CAUTI surveillance compared with 66 percent of non-VA nursing homes. VA nursing homes devoted, on average, 31 hours per week to infection-prevention activities compared with 12 hours by non-VA nursing homes, the study found. Non-VA nursing homes, however, were more likely to have policies concerning appropriate catheter use or catheter insertion. The authors concluded that the centralized infrastructure of the VA, increased numbers and training of staff, as well as the use of national VA benchmarks and leadership engagement, likely accounted for their findings. The study, “Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non-Veterans Affairs Nursing Homes,” and abstractappeared in Infection Control and Hospital Epidemiology.

2016 Dec 5:1-7. [Epub ahead of print]

Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non-Veterans Affairs Nursing Homes.

Mody L1, Greene MT2, Saint S2, Meddings J3, Trautner BW4, Wald HL5, Crnich C6, Banaszak-Holl J7, McNamara SE8, King BJ9, Hogikyan R1, Edson BS10, Krein SL2.

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Abstract

OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associatedurinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire. RESULTS A total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; P<.001) and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs 66%; P<.001), sharing CAUTI data with leadership (94% vs 70%; P=.014) and with nursing personnel (85% vs 56%, P=.003). However, fewer VAnursing homes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. Infect Control Hosp Epidemiol 2016:1-7.