Using an American Model To Reduce Catheter-Associated UTI in England with a Novel Silver Alloy Foley

Abstract

ISSUE: Nosocomial catheter-associated UTI (CA-UTI) are the commonest and most costly healthcare-associated infection (HAI) in England. The recent introduction of the silver-alloy hydrogel-coated Foley catheter to UK healthcare provides an opportunity to reduce the incidence of this HAI should U.S. results be replicated (mean reduction in CA-UTI rate of 35% recorded from approximately 250 product evaluations). Surveillance of CA-UTI is the exception, as the Department of Health's priority has been methicillin-resistant Staphylococcus aureus bacteremia. Infection Control Teams (ICTs) have been overstretched and underresourced (one Infection Control Nurse per ∼800 beds). Recently, the Chief Medical Officer published a strategy to reduce HAI which increases the amount of surveillance to be undertaken. PROJECT: Learning from U.S. Specialists how successful Performance Improvement Programs (PIP) are developed, a Quality Improvement Program (QIP) Framework has been developed by the Infection Control Clinical Consultant who can assist ICTs at all stages of the QIP as they evaluate this novel Foley. The increased unit cost of the improved product means cost-benefit analysis is integral to each QIP. RESULTS: Data for the first QIP is currently being analyzed. Several other QIP teams are collecting their baseline data at the time of writing. LESSONS LEARNED: Adapting the successful USA PIP template and experience to the National Health Service's quest for quality improvement has illustrated the variation in emphases, yet similar aims, between the two countries' healthcare systems. Reduction in CA-UTI, device-associated bacteremia and microbial resistance are common aims on both sides of the Atlantic.