{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:30:04Z","timestamp":1761514204244,"version":"3.41.0"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec id=\"S0899823X18000995_abs1\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>Collaborative programs have helped reduce catheter-associated urinary tract infection (CAUTI) rates in community-based nursing homes. We assessed whether collaborative participation produced similar benefits among Veterans Health Administration (VHA) nursing homes, which are part of an integrated system.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18000995_abs2\" sec-type=\"general\"><jats:title>SETTING<\/jats:title><jats:p>This study included 63 VHA nursing homes enrolled in the \u201cAHRQ Safety Program for Long-Term Care,\u201d which focused on practices to reduce CAUTI.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18000995_abs3\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Changes in CAUTI rates, catheter utilization, and urine culture orders were assessed from June 2015 through May 2016. Multilevel mixed-effects negative binomial regression was used to derive incidence rate ratios (IRRs) representing changes over the 12-month program period.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18000995_abs4\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>There was no significant change in CAUTI among VHA sites, with a CAUTI rate of 2.26 per 1,000 catheter days at month 1 and a rate of 3.19 at month 12 (incidence rate ratio [IRR], 0.99; 95% confidence interval [CI], 0.67\u20131.44). Results were similar for catheter utilization rates, which were 11.02% at month 1 and 11.30% at month 12 (IRR, 1.02; 95% CI, 0.95\u20131.09). The numbers of urine cultures per 1,000 residents were 5.27 in month 1 and 5.31 in month 12 (IRR, 0.93; 95% CI, 0.82\u20131.05).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18000995_abs5\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>No changes in CAUTI rates, catheter use, or urine culture orders were found during the program period. One potential reason was the relatively low baseline CAUTI rate, as compared with a cohort of community-based nursing homes. This low baseline rate is likely related to the VHA\u2019s prior CAUTI prevention efforts. While broad-scale collaborative approaches may be effective in some settings, targeting higher-prevalence safety issues may be warranted at sites already engaged in extensive infection prevention efforts.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic> 2018;820\u2013825<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2018.99","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T10:17:38Z","timestamp":1525947458000},"page":"820-825","source":"Crossref","is-referenced-by-count":8,"title":["Assessing a National Collaborative Program To Prevent Catheter-Associated Urinary Tract Infection in a Veterans Health Administration Nursing Home Cohort"],"prefix":"10.1017","volume":"39","author":[{"given":"Sarah L.","family":"Krein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Todd","family":"Greene","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth","family":"King","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Welsh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen E.","family":"Fowler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara W.","family":"Trautner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ratz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Saint","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Roselle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marla","family":"Clifton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Kralovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Martin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lona","family":"Mody","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2018,5,10]]},"reference":[{"key":"S0899823X18000995_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.12.113"},{"key":"S0899823X18000995_ref20","first-page":"21","volume":"6","year":"1988","journal-title":"Health Matrix"},{"key":"S0899823X18000995_ref17","doi-asserted-by":"publisher","DOI":"10.1086\/667743"},{"key":"S0899823X18000995_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ236"},{"key":"S0899823X18000995_ref15","first-page":"S59","volume-title":"Am J Infect Control","volume":"43","year":"2015"},{"key":"S0899823X18000995_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.228"},{"key":"S0899823X18000995_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.279"},{"key":"S0899823X18000995_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.11.017"},{"key":"S0899823X18000995_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S1553-7250(16)42091-X"},{"key":"S0899823X18000995_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02964.x"},{"key":"S0899823X18000995_ref12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504906"},{"key":"S0899823X18000995_ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-012-0380-0"},{"key":"S0899823X18000995_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2017.07.006"},{"key":"S0899823X18000995_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.3"},{"key":"S0899823X18000995_ref10","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.1689"},{"key":"S0899823X18000995_ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-011-1504-7"},{"key":"S0899823X18000995_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2009.12.009"},{"key":"S0899823X18000995_ref2","first-page":"342","volume":"61","year":"2013","journal-title":"J Am Geriatr Soc"},{"key":"S0899823X18000995_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2005.10.001"},{"key":"S0899823X18000995_ref24","first-page":"5S","volume":"113","year":"2002","journal-title":"Am J Med"},{"key":"S0899823X18000995_ref23","first-page":"38","volume":"3","year":"2016","journal-title":"Nat Center Health Statist Vital Health Stat"},{"key":"S0899823X18000995_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2015.02.023"},{"key":"S0899823X18000995_ref21","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.59"},{"key":"S0899823X18000995_ref18","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-6-201309170-00006"}],"container-title":["Infection Control &amp; 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