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Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non–Veterans Affairs Nursing Homes

Published online by Cambridge University Press:  05 December 2016

Lona Mody ,
M. Todd Greene ,
Sanjay Saint ,
Jennifer Meddings ,
Barbara W. Trautner ,
Heidi L. Wald ,
Christopher Crnich ,
Jane Banaszak-Holl ,
Sara E. McNamara  and
Beth J. King
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Lona Mody*
Affiliation:
Geriatric Research Education and Clinical Center Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan Division of Geriatric and Palliative Care Medicine, University of Michigan Medical School, Ann Arbor, Michigan
M. Todd Greene
Affiliation:
Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Sanjay Saint
Affiliation:
Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan Medicine Service, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Jennifer Meddings
Affiliation:
Medicine Service, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan
Barbara W. Trautner
Affiliation:
The Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Section of Infectious Diseases, Departments of Medicine and Surgery, Baylor College of Medicine, Houston, Texas
Heidi L. Wald
Affiliation:
Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
Christopher Crnich
Affiliation:
School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin William S. Middleton Veterans Affairs Hospital, Madison, Wisconsin
Jane Banaszak-Holl
Affiliation:
Institute of Gerontology, University of Michigan Medical School, Ann Arbor, Michigan Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan
Sara E. McNamara
Affiliation:
Division of Geriatric and Palliative Care Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Beth J. King
Affiliation:
Veterans Affairs National Center for Patient Safety, Department of Veterans Affairs, Ann Arbor, Michigan
Robert Hogikyan
Affiliation:
Geriatric Research Education and Clinical Center Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan Medicine Service, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan Division of Geriatric and Palliative Care Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Barbara S. Edson
Affiliation:
Health Research and Educational Trust, American Hospital Association, Chicago, Illinois
Sarah L. Krein*
Affiliation:
Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
*
Address correspondence to Lona Mody, MD, MSc, University of Michigan Medical School, Division of Geriatric and Palliative Medicine, 300 N. Ingalls St, Room 905, Ann Arbor, MI 48109 (lonamody@umich.edu) or Sarah L. Krein, PhD, RN, Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System, PO Box 130170, Ann Arbor, MI 48113 (skrein@umich.edu).
Address correspondence to Lona Mody, MD, MSc, University of Michigan Medical School, Division of Geriatric and Palliative Medicine, 300 N. Ingalls St, Room 905, Ann Arbor, MI 48109 (lonamody@umich.edu) or Sarah L. Krein, PhD, RN, Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System, PO Box 130170, Ann Arbor, MI 48113 (skrein@umich.edu).
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Abstract

OBJECTIVE

The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non–VA nursing homes.

SETTING

VA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative.

METHODS

Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire.

RESULTS

A total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; P<.001) and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs 66%; P<.001), sharing CAUTI data with leadership (94% vs 70%; P=.014) and with nursing personnel (85% vs 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004).

CONCLUSIONS

Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems.

Infect Control Hosp Epidemiol 2017;38:287–293

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 3 , March 2017 , pp. 287 - 293
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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