Promoting prevention through meaningful measures: Improving the Centers for Disease Control and Prevention's National Healthcare Safety Network urinary tract infection surveillance definitions

Abstract

The new year of 2015 brought with it the release of the update to the Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN) urinary tract infection (UTI) definitions. Although the NHSN UTI definitions were last updated in 2009, the inclusion of catheter-associated urinary tract infections (CAUTIs) in the Centers for Medicare and Medicaid Services' Inpatient Quality Reporting Program in 2012 heightened the challenges to the definitions by many professionals involved in infection prevention. Feedback to the CDC beginning in 2012 highlighted the gap between clinical and surveillance determinations of CAUTI, 1 Al-Qas Hanna F. Sambirska O. Iyer S. Szpunar S. Fakih M.G. Clinician practice and the National Healthcare Safety Network definition for the diagnosis of catheter-associated urinary tract infection. Am J Infect Control. 2013; 41: 1173-1177 Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar raised questions about the clinical relevance of some CAUTIs reported to the NHSN, and drew attention to variability in the application of, and adherence to, the UTI surveillance criteria and differences in clinical laboratory practices relevant to the criteria. Many commenters questioned the validity and fairness of using CAUTI data for public reporting and payment purposes and called for definitions which would more accurately measure the success of CAUTI prevention activities.