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Simplified EHR alerts reduce hospital-acquired UTI infections
More simplified automated EHR alerts for urinary catheters significantly reduced urinary tract infections, according to a study recently published in Infection Control and Hospital Epidemiology. The alerts also lead to an increase in the number of catheters removed in patients who no longer needed them.
About 75 percent of urinary tract infections acquired at hospitals are caused by a urinary catheter, according to the Center for Disease Control and Prevention. The alerts help physicians decide whether the patients need urinary catheters, and they also alert them if they have not been removed within a recommended time period.
Medical researchers and technology experts at the Perelman School of Medicine at the University of Pennsylvania created a new electronic alert that's quicker and easier to use. They then conducted a study to evaluate the efficacy of it.
The study included 222,475 inpatient admissions to the three hospitals at the university from March 2009 to May 2012. The physicians were required to record the reason for inserting the urinary catheter in the patients' EHRs. Based on the reason, alerts were made to reassess the need for the catheter if it wasn't removed within the recommended time period.
For the first phase of the study, the traditional electronic alerts were triggered and two percent of the urinary catheters were removed. But in the second phase of the study, the researchers introduced the simplified alert and 15 percent of the catheters were removed.
The study also found that catheter-associated urinary tract infections were reduced from .84 per 1,000 patient days to .70 per 1,000 patient days after the first alert was implemented, and .50 per 1,000 patient days after the simplified alert was implemented.
"By making the alert quicker and easier to use, we saw a dramatic increase in the number of catheters removed in patients who no longer needed them," Dr. Charles A. Baillie, lead author of the study and internal medicine specialist and fellow at the Center for Clinical Epidemiology and Biostatistics at Penn Medicine, said in statement. "Fewer catheters means fewer infections, fewer days in the hospital, and even, fewer deaths. Not to mention the dollars saved by the health system in general."
Previous studies have proven that reminder systems reduce the use and duration of urinary catheters and can bring down the rate of catheter infections, but most of those studies used written reminders or stickers instead of electronic alerts.
"As more hospitals adopt electronic health records, studies such as ours can help point the way toward improved patient care," Dr. Craig Umscheid, senior author of the study and assistant professor of Medicine and Epidemiology and director of Penn's Center for Evidence-based Practice, said in a statement. "Thoughtful development and deployment of technology solutions really can make a difference."
