A multicenter qualitative study on preventing hospital-acquired urinary tract infection in US hospitals

被引:72
作者
Saint, Sanjay [2 ,3 ,4 ]
Kowalski, Christine P. [2 ]
Forman, Jane [2 ]
Damschroder, Laura [2 ]
Hofer, Timothy P. [2 ,3 ,4 ]
Kaufman, Samuel R. [3 ,4 ]
Creswell, John W. [5 ]
Krein, Sarah L. [1 ,2 ,3 ]
机构
[1] Vet Affairs Hlth Serv Res & Dev Serv, Ann Arbor, MI 48105 USA
[2] Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI USA
[3] Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI 48109 USA
[4] Univ Michigan, Patient Safety Enhancement Program, Vet Affairs Med Ctr, Ann Arbor, MI 48109 USA
[5] Univ Nebraska, Lincoln, NE USA
关键词
D O I
10.1086/529589
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
OBJECTIVE. Although urinary tract infection ( UTI) is the most common hospital-acquired infection, there is little information about why hospitals use or do not use a range of available preventive practices. We thus conducted a multicenter study to understand better how US hospitals approach the prevention of hospital-acquired UTI. METHODS. This research is part of a larger study employing both quantitative and qualitative methods. The qualitative phase consisted of 38 semistructured phone interviews with key personnel at 14 purposefully sampled US hospitals and 39 in-person interviews at 5 of those 14 hospitals, to identify recurrent and unifying themes that characterize how hospitals have addressed hospital-acquired UTI. RESULTS. Four recurrent themes emerged from our study data. First, although preventing hospital-acquired UTI was a low priority for most hospitals, there was substantial recognition of the value of early removal of a urinary catheter for patients. Second, those hospitals that made UTI prevention a high priority also focused on noninfectious complications and had committed advocates, or "champions," who facilitated prevention activities. Third, hospital-specific pilot studies were important in deciding whether or not to use devices such as antimicrobial-impregnated catheters. Finally, external forces, such as public reporting, influenced UTI surveillance and infection prevention activities. CONCLUSIONS. Clinicians and policy makers can use our findings to develop initiatives that, for example, use a champion to promote the removal of unnecessary urinary catheters or exploit external forces, such public reporting, to enhance patient safety.
引用
收藏
页码:333 / 341
页数:9
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