“Lose the Tube”: A Choosing Wisely initiative to reduce catheter-associated urinary tract infections in hospitalist-led inpatient units

Cho, Hyung J.; Khalil, Steve; Poeran, Jashvant; Mazumdar, Madhu; Bravo, N. González; Wallach, Fran; Markoff, Brian; Lee, Nathan; Dunn, Andrew

doi:10.1016/j.ajic.2016.10.023

Cited by 16 publications

(6 citation statements)

References 6 publications

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“…We identified 37 relevant studies which met the inclusion criteria ( Figure S1 ) [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. Thirty-five studies were conducted in secondary care (hospital care).…”

Section: Resultsmentioning

confidence: 99%

Optimising Interventions for Catheter-Associated Urinary Tract Infections (CAUTI) in Primary, Secondary and Care Home Settings

et al. 2020

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Catheter-associated urinary tract infections (CAUTI) are common yet preventable. Healthcare professional behaviours, such as reducing unnecessary catheter use, are key for preventing CAUTI. Previous research has focused on identifying gaps in the national response to CAUTI in multiple settings in England. This study aimed to identify how national interventions could be optimised. We conducted a multi-method study comprising: a rapid review of research on interventions to reduce CAUTI; a behavioural analysis of effective research interventions compared to national interventions; and a stakeholder focus group and survey to identify the most promising options for optimising interventions. We identified 37 effective research interventions, mostly conducted in United States secondary care. A behavioural analysis of these interventions identified 39 intervention components as possible ways to optimise national interventions. Seven intervention components were prioritised by stakeholders. These included: checklists for discharge/admission to wards; information for patients and relatives about the pros/cons of catheters; setting and profession specific guidelines; standardised nationwide computer-based documentation; promotion of alternatives to catheter use; CAUTI champions; and bladder scanners. By combining research evidence, behavioural analysis and stakeholder feedback, we identified how national interventions to reduce CAUTI could be improved. The seven prioritised components should be considered for future implementation.

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Section: Resultsmentioning

confidence: 99%

Optimising Interventions for Catheter-Associated Urinary Tract Infections (CAUTI) in Primary, Secondary and Care Home Settings

et al. 2020

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“…21 Current evidence-based studies reported some measures were used to minimize the CUR, such as education and training of HCWs, an automatic reminder of electronic medical orders, and automatic cessation of medical orders. [22][23][24][25][26] In this study, we trained the HCWs in the knowledge of CAUTI prevention through hierarchical training, and regularly monitored and verified whether the indwelling catheters were reasonable. The monitoring data showed that the reasonable indwelling rate increased from 61.17% in the status grasping stage to 92.34% at the end of the QCC activities.…”

Section: Discussionmentioning

confidence: 99%

Impact of a quality control circle on the incidence of catheter-associated urinary tract infection: An interrupted time series analysis

Zhong

Xiao

Wang

et al. 2020

American Journal of Infection Control

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Background: To report a quality control circle (QCC) activity on the theme of reducing the incidence of catheter-associated urinary tract infection (CAUTI), and used an interrupted time series analysis to evaluate the impact of the QCC. Methods: In a general tertiary hospital in Shenzhen, China, we carried out a QCC activity with the theme of reducing CAUTI from April 2017 to December 2017. Before the QCC, we carried out the routine measures; during the QCC, we implemented usual measures and the countermeasures of QCC, and after the QCC, we performed the routine measures and adhered to the core measures of QCC. The interrupted time series analysis method was used to analyze the changes in the CAUTI incidence during the 3 stages. Results: Before, during, and after the QCC activities, the catheter use ratios and mean indwelling time both had a downward trend; meanwhile, the compliance rate of CAUTI prevention measures showed an upward trend. After the interventions, the CAUTI incidence decreased by 1.317% immediately, then gradually decreased by 0.510% per month. After the completion of QCC, the CAUTI incidence increased by 0.266% immediately and increased by 0.070% over time, but the difference was not statistically significant. Conclusions: The CAUTI incidence is reduced through QCC, providing a useful reference for the prevention of CAUTI and the development of medical quality improvement activities.

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“…Brett, 2018 decline in low-value practice after the intervention. 26,52,53 Research has further shown the importance of involving a range of stakeholders such as researchers, health professionals, and patients to maintain quality improvement changes in health care. 54,55 An example of how implementation science and multifaceted interventions can have lasting positive effect on integration of evidence-based recommendations into routine practice was the COVID-19 pandemic.…”

Section: Multicountrymentioning

confidence: 99%

The Effectiveness of Public Awareness Initiatives Aimed at Encouraging the Use of Evidence-Based Recommendations by Health Professionals: A Systematic Review

Tian,

Nguyen,

Chung

et al. 2024

J Patient Saf

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Objectives Public awareness initiatives have attracted growing attention globally, as a strategy to reduce low-value care and disinformation. However, knowledge gap remains in determining their effects. The aim of this systematic review was to summarize existing evidence to date on global effectiveness of public awareness initiatives. Methods Primary quantitative studies focusing on passive delivery of public awareness initiatives that targeted health professionals were included. Eligible studies were identified through search of MEDLINE, Embase, Emcare, the Cochrane Library, PsycINFO, Business Source Complete, Emerald Insight, and Google (initially on December 19, 2018, followed by updated search between July 8–10, 2019, and then between March 8–9, 2022) and the reference list of relevant studies. Methodological quality of included studies was assessed using modified McMaster critical appraisal tool. A narrative synthesis of the study outcomes was conducted. Results Twenty studies from United States, United Kingdom, Canada, Australia, and multicountry were included. Nineteen studies focused on Choosing Wisely initiative and one focused on National Institute of Clinical Excellence reminders. Most studies investigated one recommendation of a specialty. The findings showed conflicting evidence on the effectiveness of public awareness initiatives, suggesting passive delivery has limited success in reducing low-value care among health professionals. Conclusions This review highlights the complexity of change in an established practice pattern in health care. As passive delivery of public awareness initiatives has limited potential to initiate and sustain change, wide-ranging intervention components need to be integrated for a successful implementation.

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“Lose the Tube”: A Choosing Wisely initiative to reduce catheter-associated urinary tract infections in hospitalist-led inpatient units

Cited by 16 publications

References 6 publications

Optimising Interventions for Catheter-Associated Urinary Tract Infections (CAUTI) in Primary, Secondary and Care Home Settings

Optimising Interventions for Catheter-Associated Urinary Tract Infections (CAUTI) in Primary, Secondary and Care Home Settings

Impact of a quality control circle on the incidence of catheter-associated urinary tract infection: An interrupted time series analysis

The Effectiveness of Public Awareness Initiatives Aimed at Encouraging the Use of Evidence-Based Recommendations by Health Professionals: A Systematic Review

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