Device Utilization Ratios in Infection Prevention: Process or Outcome Measure?
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Purpose of Review
The purpose of this review is to describe the role of device utilization as a component of surveillance for healthcare-associated infections and describe its potential role as a measurement of healthcare quality.
Device utilization, while primarily a process-based measure in the prevention of device-associated infections can also serve as an important outcome in the evaluation of an infection prevention program.
Device utilization can be an important and resource-efficient measurement when coupled with measurements of risk-adjusted infection rates. The measurement of the device utilization ratio can provide insight into the risk of device-associated harms, including non-infectious harms, which would not be captured with currently used infection-based surveillance metrics. Further study and validation of standardized, risk-adjusted device utilization measurements is an important area for future exploration.
KeywordsDevice utilization Catheter-associated urinary tract infection Quality measurements
Compliance with Ethical Standards
Conflict of Interest
Jessica I. Abrantes-Figueiredo, Jack W. Ross, and David B. Banach declare they have no conflicts of interests.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
- 2.Healthcare-associated Infections. Available at: https://www.medicare.gov/hospitalcompare/Data/Healthcare-Associated-Infections.html. Accessed 10 Oct 2017.
- 5.•• Fakih MG, Gould CV, Trautner BW, Meddings J, Olmsted RN, Krein SL, et al. Beyond infection: device utilization ratio as a performance measure for urinary catheter harm. Infect Control Hosp Epidemiol. 2016;37(3):327–33. This paper is a description of device utilization as a metric for assessing urinary catheter-associated harm.CrossRefPubMedGoogle Scholar
- 9.National Healthcare Safety Network. Surveillance for urinary. Tract Infections. Centers for Disease Control and Prevention website. 2017; Available at: http://www.cdc.gov/nhsn/acute-care-hospital/CAUTI/index.html. Accessed 5 July 2017.
- 13.Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, 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. Clin Infect Dis. 2010;50(5):625–63.CrossRefPubMedGoogle Scholar
- 14.Centers for Medicare and Medicaid Services (CMS), HHS. Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2008 rates. Fed Regist. 2007;72(162):47129–8175.Google Scholar
- 15.Hospital-Acquired Conditions. Centers for Medicare & Medicaid Services website. 2015; Available at: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Hospital-Acquired_Conditions.html. Accessed 5 July 2017.
- 16.•• Meddings J, Reichert H, McMahon LF Jr. Challenges and proposed improvements for reviewing symptoms and catheter use to identify National Healthcare Safety Network catheter-associated urinary tract infections. Am J Infect Control. 2014;42(10 Suppl):S236–41. This paper is a comprehensive review of the challenges in identifying NHSN catheter-associated urinary tract infections.CrossRefPubMedGoogle Scholar
- 20.Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control. 2014 3:23-2994-3-23. eCollection 2014.Google Scholar
- 21.Lehmann C, Berner R, Bogner JR, Cornely OA, de With K, Herold S, et al. The “Choosing Wisely” initiative in infectious diseases. Infection. 2017:13.Google Scholar
- 25.Advani SD, Lee RA, Schmitz M, Camins BC. Impact of changes to the National Healthcare Safety Network (NHSN) definition on catheter-associated urinary tract infection (CAUTI) rates in intensive care units at an Academic Medical Center. Infect Control Hosp Epidemiol. 2017;38(5):621–3.CrossRefPubMedGoogle Scholar
- 33.Weiner LM, Webb AK, Limbago B, Dudeck MA, Patel J, Kallen AJ, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011–2014. Infect Control Hosp Epidemiol. 2016;37(11):1288–301.CrossRefPubMedGoogle Scholar
- 34.•• Hollingsworth JM, Rogers MA, Krein SL, Hickner A, Kuhn L, Cheng A, et al. Determining the noninfectious complications of indwelling urethral catheters: a systematic review and meta-analysis. Ann Intern Med. 2013;159(6):401–10. This paper is a thorough, systematic review of clinical trials and observational studies describing the frequency of noninfectious urinary catheter-associated complications.CrossRefPubMedGoogle Scholar
- 40.Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract Infection [UTI]) and Other Urinary System Infection [USI]) Events. 2017; Available at: https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf. Accessed 5 July 2017.