Adopting Simplified EHR Alerts Greatly Reduces UTIs, Study Finds

August 22, 2014 in News

Electronic health record alerts can help to reduce the number of urinary tract infections among hospitalized patients, according to a University of Pennsylvania study, EHR Intelligence reports (Bresnick, EHR Intelligence, 8/22).

The study will be published in the September issue of Infection Control and Hospital Epidemiology.

Background

According to the study, about 75% of hospital-acquired UTIs are associated with urinary catheterization. Up to 70% of the UTIs might be preventable if hospitals instituted certain measures to control infections, such as removing catheters that are no longer needed.

Details of Study

For the study, researchers analyzed data from 222,475 inpatient admissions at the University of Pennsylvania Health System’s three hospitals between March 2009 and May 2012 (Penn Medicine release, 8/21).

When documenting a catheterization in an EHR, physicians were prompted to write the reason for the procedure and what time it took place. The system then triggered an alert at the end of the recommended time period prompting the provider to either remove the catheter or re-evaluate its use, based on the reason for its insertion (EHR Intelligence, 8/22).

For the first phase of the study, physicians were notified via an EHR alert that was part of the standard EHR software package.

For the second phase, physicians were notified via a simplified alert that reduced the number of mouse clicks needed to submit an order to remove the catheter, among other improvements. The simplified alert was developed using national guidelines on removing urinary catheters previously released by Penn Medicine and CDC.

Findings

During the first phase of the study, 2% of catheters were removed after the EHR system’s default alert was triggered, reducing associated UTIs from .84 per 1,000 patient days to .70 per 1,000 patient days.

During the second phase, 15% of catheters were removed after the simpler EHR alert was triggered, further reducing associated UTIs to .50 per 1,000 patient days.

Alerts most often led to catheter removals within women’s health units, while critical care units had the lowest rates of catheter removals after alerts, according to the researchers.

Implications

Charles Baillie, lead author of the study, said, “Fewer catheters means fewer infections, fewer days in the hospital and even fewer deaths,” adding, “Not to mention the dollars saved by the health system in general.”

Craig Umscheid, another author of the study and an assistant professor at the University of Pennsylvania’s Center for Evidence-based Practice, said, “As more hospitals adopt electronic health records, studies such as ours can help point the way toward improved patient care” (Penn Medicine release, 8/21).

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