Intervention Reduces Urinary Tract Infection Risk in Kids

Quality-improvement initiative reduces catheter-associated UTI rates in children.
Quality-improvement initiative reduces catheter-associated UTI rates in children.

Enactment of a quality improvement prevention bundle at a tertiary care children's hospital significantly reduced the rate of catheter-associated urinary tract infections (CAUTIs), according to research published online in Pediatrics.

Katherine Finn Davis, R.N., Ph.D., of the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective cohort study to assess the epidemiology of incident pediatric CAUTIs at a children's hospital during a three-year period. The researchers also examined the impact of a CAUTI quality improvement bundle, which included practice standards for insertion and maintenance of urinary catheters, staff training, daily review of need for a catheter, and rapid review of all CAUTIs.

The researchers observed a 50 percent reduction in the mean monthly CAUTI rate from 5.41 to 2.49 per 1,000 catheter-days (95 percent confidence interval, −1.28 to −0.12; P = 0.02) following implementation of the CAUTI prevention bundle. Most pediatric patients with CAUTIs were female (75 percent), were admitted to the pediatric or cardiac intensive care unit (70 percent), and had at least one complex chronic medical condition (98 percent). Almost 90 percent of patients who developed a CAUTI had a recognized indication for urinary catheterization.

"CAUTI is a common pediatric health care-associated infection," the authors write. "Implementation of a prevention bundle can significantly reduce CAUTI rates in children."

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