A Multicenter Qualitative Study on Preventing Hospital-Acquired Urinary Tract Infection in US Hospitals

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

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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Catheters, Indwelling / adverse effects*
  • Cross Infection / prevention & control*
  • Decision Making, Organizational
  • Hospitals
  • Humans
  • Infection Control / methods*
  • Interviews as Topic
  • Qualitative Research
  • United States
  • Urinary Catheterization / adverse effects*
  • Urinary Tract Infections / prevention & control*

Substances

  • Anti-Bacterial Agents