Implementing targeted electronic alerts in EHRs may significantly reduce the occurrence of catheter-associated urinary tract infections, according to a study in Infection Control and Hospital Epidemiology.
The research team implemented a clinical decision support intervention into the EHR in which providers were prompted to insert information regarding the indication for the urinary catheter insertion. Based on the indication, the CDS then alerted providers to reassess the need for the urinary catheter if it was not removed in the recommended time. The study analyzed 22,475 inpatient admissions in Philadelphia-based University of Pennsylvania Health System's three hospitals between March 2009 and May 2012.
After the initial alert period, 2 percent of urinary catheters were removed. Researchers then developed a simplified alert based on national guidelines for removing urinary catheters published by the Centers for Disease Control and Prevention. After introducing the second alert, 15 percent of urinary catheters were removed.
Furthermore, the rate of CAUTIs fell from 0.84 per 1,000 patient days to 0.51 per 1,000 patient days after implementing the second alert.
"Our study has two crucial, applicable findings," said Charles Baillie, MD, the lead author of the study, in a Penn Medicine news release. "First, electronic alerts do result in fewer catheter-associated urinary tract infections. Second, design of the alerts is very important. By making the alert quicker and easier to use, we saw a dramatic increase in the number of catheters removed in patients who no longer needed them. Fewer catheters means fewer infections, fewer days in the hospital and even fewer deaths."
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