Preventing Catheter Associated Urinary Tract Infections

Catheter-associated urinary tract infections are the most commonly reported device-associated hospital-acquired infections. An important risk factor for developing such an infection is prolonged use of the urinary catheter. A urinary catheter may be necessary for certain conditions such as an inability to urinate or to accurately measure urine output when a patient is critically ill.

At Cedars-Sinai, many precautions are taken to prevent these infections, including:

  • Properly cleaning the hands before putting in the catheter
  • Carefully avoiding contamination of the drainage spigot when emptying
  • Positioning tubing and bag always below bladder level, off the floor
  • Checking the system for closed connections and no obstructions/kinks
  • Ensuring the seal is closed and intact, and replacing the complete system if the seal is found broken in a nonaseptic manner
  • Removing the catheter as soon as it is no longer needed

As part of its commitment to improving the quality of care given to patients at Cedars-Sinai, the rate of central line infections is monitored carefully.

California hospitals are required to report these infections to the California Department of Public Health and the National Healthcare Safety Network, part of the Centers for Disease Control and Prevention (CDC). The California department is required to adjust the data for risk factors according to the federal network's protocols. The risk adjustment methodology uses national data to compare the actual number of infections to the expected number, based on the age and health of the surgery patients.

The chart below shows the rate of catheter associated urinary tract infections that occurred in patients in the Adult Intensive Care Units at Cedars-Sinai vs. the expected number.

What Is the Standardized Infection Ratio?

The standardized infection ratio is a summary measure used to track infections at a national, state or local level over time. The ratio compares the actual number of infections reported to what would be predicted, adjusting for risk factors that have been found to be significantly associated with differences in infection incidence. A lower number is better.

Impact on Standardized Infection Ratios After 2015 Rebaselining

The National Healthcare Safety Network instituted the new 2015 baseline time period for the number predicted calculation. The data included in the 2015 baseline will serve as a new reference point for comparing progress. CDC expects that hospital standardized infection ratios will increase and shift closer to 1. This shift reflects nationwide improvement in infection prevention from the previous baseline time period.