Document Type
Article
Language
eng
Publication Date
7-2019
Publisher
Public Library of Science (PLoS)
Source Publication
PLoS ONE
Source ISSN
1932-6203
Abstract
Catheter-associated asymptomatic bacteriuria (CAABU) is frequent in intensive care units (ICUs) and contributes to the routine use of antibiotics and to antibiotic-resistant infections. While nurses are responsible for the implementation of CAABU-prevention guidelines, variability in how individual nurses contribute to CAABU-free rates in ICUs has not been previously explored. This study’s objective was to examine the variability in CAABU-free outcomes of individual ICU nurses. This observational cross-sectional study used shift-level nurse-patient data from the electronic health records from two ICUs in a tertiary medical center in the US between July 2015 and June 2016. We included all adult (18+) catheterized patients with no prior CAABU during the hospital encounter and nurses who provided their care. The CAABU-free outcome was defined as a 0/1 indicator identifying shifts where a previously CAABU-free patient remained CAABU-free (absence of a confirmed urine sample) 24–48 hours following end of shift. The analytical approach used Value-Added Modeling and a split-sample design to estimate and validate nurse-level CAABU-free rates while adjusting for patient characteristics, shift, and ICU type. The sample included 94 nurses, 2,150 patients with 256 confirmed CAABU cases, and 21,729 patient shifts. Patients were 55% male, average age was 60 years. CAABU-free rates of individual nurses varied between 94 and 100 per 100 shifts (Wald test: 227.88, P<0.001) and were robust in cross-validation analyses (correlation coefficient: 0.66, P<0.001). Learning and disseminating effective CAABU-avoidance strategies from top-performers throughout the nursing teams could improve quality of care in ICUs.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Yakusheva, Olga; Costa, Deena K.; Bobay, Kathleen L.; Parada, Jorge P.; and Weiss, Marianne E., "Variability in Catheter-Associated Asymptomatic Bacteriuria Rates Among Individual Nurses in Intensive Care Units: An Observational Cross-Sectional Study" (2019). College of Nursing Faculty Research and Publications. 631.
https://epublications.marquette.edu/nursing_fac/631
Comments
Published version. PLoS ONE, Vol. 14, No. 7 (July 2019): e0218755. DOI. © 2019 PLoS. Used with permission.
Olga Yakusheva was affiliated with University of Michigan at the time of publication.
Kathleen Bobay was affiliated with Loyola University at the time of publication.