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VA research in action

Bladder bundle program significantly reduces catheter-associated urinary tract infections

August 1, 2018


Photo ©iStock/luismmolina

A "bladder bundle" set of practices developed by VA Ann Arbor Healthcare System researchers has been adopted nationwide, in both VA and non-VA hospitals, as a way to reduce catheter-associated urinary tract infections (CAUTI). Urinary tract infection is one of the leading causes of infection among nursing home residents. Catheters are one of the main sources of urinary tract infections in this population.

The bladder bundle aims to prevent these infections through the use of five key practices: 1) catheter removal, 2) aseptic insertion, 3) use regular assessments, 4) training for catheter care, and 5) incontinence care planning. These practices focus on avoiding unneeded and harmful catheters, maintaining the best hygiene and application techniques, and making sure caregivers have the best training and assessment tools to help patients with catheters.

As a result of this work, CAUTI rates fell significantly in VA care. This led to the bladder bundle's being implemented nationally in more than 1,000 hospitals. CAUTI rates fell by 54 percent in both VA and non-VA community-based nursing homes in 48 states, Washington, D.C., and Puerto Rico after the initiative.

Project title: Translating infection prevention evidence to enhance patient safety

Principal investigators: Sara L. Krein, PhD, RN, Sanjay Saint, MD, MPH; VA Ann Arbor Healthcare System

Selected publications:

Mody L, Greene M, Meedings J, Krein S, McNamara SE, Trautner BW, Ratz D, Stone ND, Min L, Schweon SJ, Rolle AJ, Olmsted RN, Burwen DR, Battles J, Edson B, Saint S. A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents. JAMA Intern Med. 2017 Aug 1;177(8):1154-1162.

Research partners: Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, American Hospital Association, Association for Professionals in Infection Control and Epidemiology

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