Jennifer Meddings, MD, MSc; Milisa Manojlovich, PhD, RN; Karen E. Fowler, MPH; Jessica M. Ameling, MPH; Linda Greene, RN, MPS, CIC; Sue Collier, MSN, RN; Jay Bhatt, DO, MPH, MPA; Sanjay Saint, MD, MPH
Disclaimer: The findings and conclusions in this report are those of the authors and do not represent the official position of the CDC, the American Hospital Association, or the Department of Veterans Affairs.
Acknowledgment: The authors thank the Health Research & Educational Trust (HRET) Health Care-Associated Infection team, as well as the National Program Team and all members of the CDC STRIVE collaborative.
Financial Support: Dr. Meddings' work was partially funded by concurrent support from AHRQ (K08 HS19767).
Disclosures: Dr. Meddings, Dr. Manojlovich, Ms. Fowler, Ms. Ameling, and Dr. Saint report a contract from the CDC with the HRET, which subcontracted with the University of Michigan to support faculty/staff effort for this contract, during the conduct of the study. Dr. Meddings also reports an AHRQ K08 grant during the conduct of the study; employment by the University of Michigan Medical School (Michigan Medicine), VA Ann Arbor Healthcare System, and the Center for Clinical Management Research; being an investigator on an AHRQ contract with HRET; and receipt of honoraria for presentations from various professional and nonprofit organizations and QuantiaMD outside the submitted work. In addition, Dr. Meddings' research involves development of products to improve patient safety by reducing hospital-acquired complications, and her team has a provisional patent involving one of these products (US20180339133A1). She has no associations with any companies or manufacturers, has no ownership in a commercial entity, and receives no royalties. Ms. Greene reports payment for time spent on catheter-associated urinary tract infection projects from Association of Professionals in Infection Control outside the submitted work. Ms. Collier reports a CDC contract with HRET during the conduct of the study. Dr. Bhatt reports grants from the AHRQ and the CDC during the conduct of the study. Dr. Saint also reports personal fees from Doximity and Jvion, during the conduct of the study. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3471.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor, Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Corresponding Author: Jennifer Meddings, MD, MSc, University of Michigan Department of Internal Medicine, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109-2800; e-mail, Meddings@umich.edu.
Current Author Addresses: Drs. Meddings and Saint: University of Michigan Department of Internal Medicine, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI 48109-2800.
Dr. Manojlovich: University of Michigan School of Nursing, 400 North Ingalls Building, Room 4306, Ann Arbor, MI, 48109-5482
Ms. Fowler: Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, PO Box 130170, Ann Arbor, MI 48113-0170.
Ms. Ameling: University of Michigan Department of Internal Medicine, 2800 Plymouth Road, NCRC Building 16, Room 430W, Ann Arbor, MI 48109-2800.
Ms. Greene: Infection Prevention Department, University of Rochester Highland Hospital, 1000 South Avenue, Rochester, NY 14620.
Ms. Collier: North Carolina Healthcare Foundation, 2400 Weston Parkway, Cary, NC 27513.
Dr. Bhatt: Health Research & Educational Trust, American Hospital Association, 155 North Upper Wacker Drive, #400, Chicago, IL 60606.
Author Contributions: Conception and design: J. Meddings, K.E. Fowler, J. Bhatt, S. Saint.
Analysis and interpretation of the data: J. Meddings, M. Manojlovich.
Drafting of the article: J. Meddings, J.M. Ameling, J. Bhatt.
Critical revision of the article for important intellectual content: J. Meddings, M. Manojlovich, K.E. Fowler, J.M. Ameling, L. Greene, S. Collier, J. Bhatt, S. Saint.
Final approval of the article: J. Meddings, M. Manojlovich, K.E. Fowler, J.M. Ameling, L. Greene, S. Collier, J. Bhatt, S. Saint.
Obtaining of funding: S. Collier, J. Bhatt, S. Saint.
Administrative, technical, or logistic support: K.E. Fowler, J.M. Ameling, S. Collier.
Collection and assembly of data: J. Meddings, M. Manojlovich.
Appendix Table. The CAUTI Metric
Tiered approach to prioritize interventions to prevent CAUTI.
This material was expanded, enhanced, and adapted from materials developed for CAUTI prevention by faculty and staff at the Department of Veterans Affairs and the University of Michigan with funding support from the Agency for Healthcare Research and Quality. Further adaptation was done with funding support from the Centers for Disease Control and Prevention. CAUTI = catheter-associated urinary tract infection; GPS = guide to patient safety; TAP = Targeted Assessment for Prevention; UTI = urinary tract infection.
Meddings J, Manojlovich M, Fowler KE, et al. A Tiered Approach for Preventing Catheter-Associated Urinary Tract Infection. Ann Intern Med. 2019;171:S30–S37. doi: https://doi.org/10.7326/M18-3471
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Published: Ann Intern Med. 2019;171(7_Supplement):S30-S37.
Hospital-Acquired Infections, Infectious Disease, Nephrology, Urinary Tract Infection, Urological Disorders.
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