A Penn Medicine team has found that targeted automated alerts in electronic health records significantly reduce urinary tract infections in hospital patients with urinary catheters. In addition, when the design of the alert was simplified, the rate of improvement dramatically increased.
The alerts help physicians decide whether their patients need urinary catheters in the first place and then alert them to reassess the need for catheters that have not been removed within a recommended time period. The electronic alert, developed by medical researchers and technology experts at the
Approximately 75 percent of urinary tract infections acquired in the hospital are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. According to the
"Our study has two crucial, applicable findings," said the Penn study's lead author
In the first phase of the study, two percent of urinary catheters were removed after an initial "off-the-shelf" electronic alert was triggered (the stock alert was part of the standard software package for the electronic health record). Hoping to improve on this result in a second phase of the study, Penn experts developed and used a simplified alert based on national guidelines for removing urinary catheters they had previously published with the CDC. Following introduction of the simplified alert, the proportion of catheter removals increased more than seven-fold to 15 percent.
The study also found that catheter associated urinary tract infections decreased from an initial rate of .84 per 1,000 patient days to .70 per 1,000 patient-days following implementation of the first alert and .50 per 1,000 patient days following implementation of the simplified alert. Among other improvements, the simplified alert required two mouse clicks to submit a remove-urinary-catheter order compared to seven mouse clicks required by the original alert.
The study was conducted among 222,475 inpatient admissions in the three hospitals of the
Women's health units had the highest proportion of alerts that led to a remove-urinary-catheter order and critical care units saw the lowest proportion of alerts leading to a remove order.
"As more hospitals adopt electronic health records, studies such as ours can help point the way toward improved patient care," said senior author
Several studies have already shown that reminder systems to limit the use and duration of urinary catheters can lower catheter infection rates. However, the majority of these have used non-computerized reminders, such as written reminders or stickers. The current Penn study is one of the largest to examine the impact of electronically generated alerts. In addition to the size of the study, a second strength is its multi-year duration. Most prior studies relied on a brief study period, and several studies observed an increase in catheter use when the relatively brief intervention had ended.
In addition to Baillie and Umscheid, other Penn Medicine co-authors are
TNS 18DejucosGrace-140823-30FurigayJane-4836555 30FurigayJane
Most Popular Stories
- Michael Jackson, Freddie Mercury on Previously Unreleased Queen Cut
- 10 Things to Know About Alibaba
- Five Steps to Protect Yourself from Data Breaches
- Concur Sold to SAP for $8.3B
- Chrysler Recalls Nearly 189,000 SUVs
- Intruder Gets into White House
- Federal Probe Finds Christie Did Not Order 'Bridgegate'
- HCL America Adding 1,200 IT Jobs
- Medical Mfg. Jobs Coming to Dayton
- Longtime Unemployed to Get Help in Las Vegas