Effect of Non-Infection Prevention Champions on Catheter-Associated Urinary Tract Infection Rates

Abstract

BACKGROUND The Healthcare-Associated Infections and Antibiotic Resistance Program of the Louisiana Department of Health (LDH) conducted 25 infection control assessment and response (ICAR) surveys in acute care hospitals between 2015 and 2018. Survey domains include questions on physician and/or nurse champions for prevention activities. LDH HAI/AR Program aimed to determine if facilities that have non-IP champions for catheter-associated urinary tract infection (CAUTI) prevention experience fewer infections than facilities that either have IP champions or no champions at all. METHODS The CAUTI domain of ICAR surveys were reviewed. Responses were categorized into five groups: 1) no champion, 2) IP champion, 3) non-unit-based multidisciplinary champion teams, 4) unit-based non-IP champions, and 5) champions who had unspecified designations. Infection and device-day denominator data from 2015 to 2017 for each facility were extracted from the LDH National Healthcare Safety Network (NHSN) group. Incidence density rates were compared by year and between each category. Similar, by-year comparisons were conducted using IP champions as the reference group and collapsing categories 3, 4, and 5. P-values were assessed for statistical significance at the 95% confidence level using NHSN's Statistics Calculator. RESULTS There were four facilities with no champion, six with an IP champion, seven with multidisciplinary teams, seven with unit-based champions, and one with a champion with unspecified designation. Non-IP champion facilities (categories 3-5) experienced fewer infections per 1,000 device days (p=0.0223) in 2015. Subsequent years showed non-significant comparisons between these groups. Facilities with non-IP champions had significantly lower rates than hospitals with IP champions only in 2015 (p=0.0018). Comparisons for 2016-2017 between these groups were non-significant. CONCLUSIONS Although results were mixed, marginal data showed non-IP champions experienced fewer infections. Gold standard IP programs include unit-based champions who promote infection prevention among bedside clinicians. Results will be shared to encourage a shared culture of patient safety.