When providing medical services, complications may arise due to the peculiarities of treatment. Such a situation can lead to deterioration of the patient’s condition, more extended hospital stay, dissatisfaction with services, and a higher cost of treatment, but it can be prevented (U.S. Centers for Medicare and Medicaid Services [CMS], n.d.). Therefore, the study and prevention of healthcare-associated infections (HAIs) is an essential focus of the activities of medical organizations and facilities (Centers for Disease Control and Prevention [CDC], 2021). Tracking data about different HAIs is crucial for assessing and understanding the situation. The current paper considers the catheter-associated urinary tract infections (CAUTI) measurement in acute care hospitals (ACHs) at the local, state, and national levels.
HAIs are a significant consequence of treatment and require careful study. Particularly, CAUTI is a urinary tract infection (UTI), that occurs after the indwelling catheters have been used for the patient for more than two days before the start of the infection (National Healthcare Safety Network [NHSN], 2022). To confirm the association with the catheter when it is removed, the complication must manifest itself on the same day the catheter is discontinued or the day after (NHSN, 2022). Denominator and numerator data are used to calculate the spread of the disease, risks, and other measures. In the case of CAUTI, a UTI form is used for the numerator, and it includes demographic data, information on compliance with the criteria for diagnosing infection, the presence of bloodstream infection, and organisms from cultures with their antimicrobial susceptibilities (NHSN, 2022). Denominators, in turn, are presented by data on patient and device days (NHSN, 2022). Methods of collecting denominator data may vary depending on the patient’s location.
HAI data can be monitored at different levels – local, state, or national levels. This paper considers data in the United States and highlights the state of interest – New York with the local ACH – NYU Langone Hospitals. According to CMS (2022), the rate for CAUTI at NYU Langone Hospitals is 0.504, which is a good indicator. The comparative benchmark is the national level indicator set in 2015 – 1 (CDC, 2021). Numbers below 1 mean the number of complications in question is less than expected.
Data at the national level are presented for review by the CDC. 2020 national and state HAI progress report presents data on CAUTI national standardized infection ratios (SIRs) in Table 2a (CDC, 2020). Nationally, the SIR for CAUTI is 0.754, with rates in observed events – 19,738 and predicted events – 26,177.03, representing a difference of 6,439.03 (CDC, 2020). The table also contains confidence interval (CI) data for consideration. This indicator reflects the point estimate range with possible probability (McBride & Teitz, 2022). For CAUTI, the lower CI limit is 0.744, and the upper limit is 0.765, which means a possible SIR error of 0.01 (CDC, 2020). The HAI report is also helpful for examining more specific data in states.
The considered report also presents state-specific indicators in Table 4a. SIR rates for CAUTI in New York State are 0.695, where the observed number of cases is 983, and the predicted is 1415.345, with a difference of 432.345 (CDC, 2020). The CI limits for New York are 0.652 and 0.739, which means an error of 0.04 (CDC, 2020). Such data help to assess the current situation with CAUTI.
Thus, organizations provide information on CAUTI to understand its frequency and prevalence in various organizations. Considering the complication rate at NYU Langone Hospital, ACH in New York, the rate is 0.504. This SIR is better than the state-level indicator of 0.695 and the national one of 0.754, which suggests evidence of the hospital’s efforts to prevent CAUTI. Nevertheless, rates at all levels are less than 1, meaning medical staff is taking action to improve their services in various facilities.
References
Centers for Disease Control and Prevention. (2020). 2020 national and state HAI progress report: Acute care hospitals. Web.
Centers for Disease Control and Prevention. (2021). Current HAI progress report. Web.
McBride, S., & Teitz, M. (2022). Nursing informatics for the advanced practice nurse: Patient safety, quality, outcome, and interprofessionalism. Springer Publishing Company.
National Healthcare Safety Network. (2022). Patient safety component manual. Web.
U.S. Centers for Medicare and Medicaid Services. (2022). NYU Langone Hospitals: Complications & deaths. Web.
U.S. Centers for Medicare and Medicaid Services. (n.d.). Complications & deaths. Web.