Study: Simplified EHR alerts cut catheter-associated UTIs

Targeted automated alerts in EHRs can help significantly curb urinary tract infections (UTIs) in hospital patients with urinary catheters, according to research conducted at the Perelman School of Medicine at the University of Medicine. Also, design of the alerts strongly impacts their success.

About three-fourths of UTIs acquired in hospitals are associated with a urinary catheter and up to 70 percent of such infections may be preventable using control measures such as removing no longer needed catheters--resulting in up to 380,000 fewer infections and 9,000 fewer deaths each year, according to Penn Medicine.

The school's study, published in Infection Control and Hospital Epidemiology, was conducted among 222,475 inpatient admissions in three hospitals between March 2009 and May 2012.

In the initial phase of the study, two percent of urinary catheters were removed after the EHR’s stock electronic alert was triggered. To improve upon this, Penn experts developed and simplified the alert based on national guidelines for removing urinary catheters they had previously published with the Centers for Disease Control and Prevention. Following introduction of the simplified alert, the proportion of catheter removals increased to 15 percent.

The catheter-associated UTI decreased from .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.

“Thoughtful development and deployment of technology solutions really can make a difference. In this study, we learned that no two alerts are alike, and that changes to an alert’s usability can dramatically increase its impact,” said Craig Umscheid, MD, assistant professor of medicine and epidemiology and director of Penn’s Center for Evidence-based Practice.