When it comes to infection control in the intensive care unit, bigger is not always better, according to a study published this month in the Journal of Infection Control. Researchers at Columbia University School of Nursing found that ICUs in hospitals with more than 500 beds are half as likely as those in smaller hospitals to have adopted at least one prevention policy for catheter-associated urinary tract infections (CAUTI).
What's more, larger hospitals, while less likely to implement CAUTI prevention, have a higher incidence of CAUTIs than smaller hospitals with fewer than 500 beds.
"What we find so baffling is that the very hospitals that have the highest rates of CAUTI are not following the CAUTI preventive guidelines in their intensive care units," study lead author Laurie J. Conway, a pre-doctoral trainee at the Columbia University School of Nursing, said yesterday in a statement.
Infection control experts have recommended several CAUTI prevention policies, such as using bladder ultrasound scanners to spot urinary retention, as well as using automated reminders or stop orders to discontinue catheters once they're no longer needed.
But recent federal regulations that require public reporting of CAUTI rates could get hospitals of all sizes focused on preventing CAUTIs in their ICUs, according to the research announcement.
In fact, such reporting has helped hospital operating rooms reduce infections and reinforced the need for a national standard for publicly reporting surgical site infections, according to a March report from Johns Hopkins Medicine.