Electronic alerts can help reduce urinary tract infections in hospital patients with urinary catheters, a new research study at Penn Medicine has revealed.
Using data from 222,475 inpatient admissions in the three hospitals of the University of Pennsylvania Health System over the course of three years, the researchers were able to conclude that targeted automated alerts in the electronic health record (EHR) system reduced urinary tract infections in hospital patients with urinary catheters by a significant amount. According to Penn Medicine, 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. Many of these infections are preventable, researchers say.
In patients' EHR, doctors were prompted to specify why they were inserting a urinary catheter. Depending on the choice they selected, they were alerted to reassess the need for the catheter if it had not been removed within the recommended time period based on the reason chosen. The alerts were implemented in two phases, with the second one involving a more simplified alert for clinicians that allowed an order of a catheter to be removed in two clicks of a mouse.
According to their findings, 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. The researchers found that 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," stated the research paper's senior author Craig Umscheid, M.D., an assistant professor of Medicine and Epidemiology and director of Penn's Center for Evidence-based Practice. "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."