Rates of catheter-associated urinary tract infections (CAUTIs) dropped by 54 percent across more than 400 long-term care facilities that participated in a patient safety project funded by the Agency for Healthcare Research and Quality (AHRQ), according to a study published today in JAMA Internal Medicine.

The project adapted AHRQ’s Comprehensive Unit-based Safety Program (CUSP) for use in long-term care facilities. Previous AHRQ efforts to implement CUSP and other safety programs in hospitals have led to significant reductions in CAUTIs and bloodstream infections associated with central line catheters.

We continue to see the power of AHRQ tools to help front-line staff tackle safety problems, now in nursing homes as well as hospitals,” said Jeffrey Brady, M.D., M.P.H., director of AHRQ’s Center for Quality Improvement and Patient Safety. “This means that some of the most vulnerable members of society – those who reside in long-term care facilities and nursing homes – are less likely to be harmed as a result of infections.”

CAUTI is a type of healthcare-associated infection (HAI) that is common in long-term care facilities, where up to 10 percent of residents have urinary catheters. CAUTI can sometimes lead to severe illness and hospitalization and generates significant expenses for antibiotics and hospitalizations. The infections are generally treatable with antibiotics, but long-term or repeated use of antibiotics can increase the risk of other infections as well as lead to development of antibiotic resistance.

CUSP is designed to promote improvement in leadership, teamwork, communication and safety culture to facilitate consistent use of evidence-based practices for infection prevention.  During the project, CAUTI rates dropped from about 6.4 to 3.3 per 1,000 catheter days. Three-quarters of the facilities showed a CAUTI rate reduction of at least 40 percent, indicating that this approach could benefit a majority of long-term care facilities.

To help doctors, nurses and other leaders in all long-term care facilities prevent CAUTIs, AHRQ has released a Toolkit to Reduce CAUTIs and Other HAIs in Long-Term Care Facilities. This practical resource is based on the experiences of facilities that participated in the project. It includes checklists and other tools and educational materials to guide facilities that seek to apply infection-reduction programs.

AHRQ, part of the Department of Health and Human Services (HHS), works with other federal agencies, researchers, and providers to prevent and reduce HAIs and combat antibiotic-resistant bacteria. AHRQ’s mission is to produce evidence to make health care safer, higher quality, more accessible, equitable and affordable and to work within HHS and with other partners to make sure that the evidence is understood and used. For more information about AHRQ’s work to prevent HAIs, visit www.ahrq.gov/hais.

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