What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States

Infect Control Hosp Epidemiol. 2023 Dec;44(12):1913-1919. doi: 10.1017/ice.2023.65. Epub 2023 Jun 1.


Objective: The ways that device-associated infection prevention practices changed during the coronavirus disease 2019 (COVID-19) pandemic remain unknown. We collected data mid-pandemic to assess the use of several infection prevention practices and for comparison with historical data.

Design: Repeated cross-sectional survey.

Setting: US acute-care hospitals.

Participants: Infection preventionists.

Methods: We surveyed infection preventionists from a national random sample of 881 US acute-care hospitals in 2021 to estimate the current use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated events (VAE). We compared the 2021 results with those from surveys occurring every 4 years since 2005.

Results: The 2021 survey response rate was 47%; previous survey response rates ranged from 59% to 72%. Regular use of most practices to prevent CLABSI (chlorhexidine gluconate for site antisepsis, 99.0%, and maximum sterile barrier precautions, 98.7%) and VAE (semirecumbent positioning, 93.4%, and sedation vacation, 85.8%) continued to increase or plateaued in 2021. Conversely, use of several CAUTI prevention practices (portable bladder ultrasound scanner, 65.6%; catheter reminders or nurse-initiated discontinuation, 66.3%; and intermittent catheterization, 37.3%) was lower in 2021, with a significant decrease for some practices compared to 2017 (P ≤ .02 for all comparisons). In 2021, 42.1% of hospitals reported regular use of the newer external urinary collection devices for women.

Conclusions: Although regular use of CLABSI and VAE preventive practices continued to increase (or plateaued), use of several CAUTI preventive practices decreased during the COVID-19 pandemic. Structural issues relating to care during the pandemic may have contributed to a decrease in device-associated infection prevention practices.

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Catheter-Related Infections* / epidemiology
  • Catheter-Related Infections* / prevention & control
  • Cross Infection* / epidemiology
  • Cross Infection* / prevention & control
  • Cross-Sectional Studies
  • Female
  • Health Care Surveys
  • Hospitals
  • Humans
  • Infection Control / methods
  • Pandemics / prevention & control
  • Pneumonia, Ventilator-Associated* / epidemiology
  • United States / epidemiology
  • Urinary Tract Infections* / epidemiology
  • Urinary Tract Infections* / prevention & control