UTI: Clinical and System Reviews, Incident Analyses
Given the broad range of potential causes of hospital associated UTI, clinical and system reviews should be conducted to identify latent causes and determine appropriate recommendations.
Occurrences of harm are often complex with many contributing factors. Organizations need to:
- Measure and monitor the types and frequency of these occurrences.
- Use appropriate analytical methods to understand the contributing factors.
- Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.
- Have mechanisms in place to mitigate consequences of harm when it occurs.
To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the section Resources for Conducting Incident and/or Prospective Analyses section of the Hospital Harm Improvement Resources Introduction.
If your review reveals that your cases of UTI are linked to specific processes or procedures, you may find these resources helpful:
- Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada) ammi.ca
- Association for Professionals in Infection Control and Epidemiology (APIC) apic.org
- Association for Professionals in Infection Control and Epidemiology. APIC Implementation Guide: Guide to Preventing Catheter-Associated Urinary Tract Infections. APIC; 2014. a rel="noopener" href="https://apic.org/professional-practice/implementation-guides/#implementaion-guide-7454" target="_blank">https://apic.org/professional-practice/implementation-guides/#implementaion-guide-7454
- Canadian Urological Association Journal cuaj.ca
- Centers for Disease Control and Prevention (CDC). www.cdc.gov
- Cochrane Library https://www.cochranelibrary.com/
- Heart & Lung - The Journal of Cardiopulmonary and Acute Care https://www.heartandlung.org/
- Conway LJ, Larson EL. Guidelines to prevent catheter-associated urinary tract infection: 1980 to 2010. Heart & Lung: The Journal of Cardiopulmonary and Acute Care. 2012;41(3):271-283. doi:10.1016/j.hrtlng.2011.08.001 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362394/
- Infectious Diseases Society of America www.idsa.org
- Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clinical Infectious Diseases. 2010;50(5):625-663. doi:10.1086/650482 http://cid.oxfordjournals.org/content/50/5/625.long
- Infection Prevention and Control Canada (IPAC CANADA) ipac-canada.org
- Institute for Healthcare Improvement (IHI) www.ihi.org
- International Journal for Quality Health Care https://academic.oup.com/intqhc
- Clarke K, Tong D, Pan Y, et al. Reduction in catheter-associated urinary tract infections by bundling interventions. International Journal for Quality in Health Care. 2013;25(1):43-49. doi:10.1093/intqhc/mzs077 http://intqhc.oxfordjournals.org/content/25/1/43
- Journal of Nursing Care Quality https://journals.lww.com/jncqjournal/pages/default.aspx
- New England Journal of Medicine www.nejm.org