{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T07:59:43Z","timestamp":1770537583364,"version":"3.49.0"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":1281,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:sec id=\"S0195941700040467_abs1\"><jats:title>Objective.<\/jats:title><jats:p>To evaluate two different methods of measuring catheter-associated urinary tract infection (CAUTI) rates in the setting of a quality improvement initiative aimed at reducing device utilization.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700040467_abs2\"><jats:title>Design, Setting, and Patients.<\/jats:title><jats:p>Comparison of CAUTI measurements in the context of a before-after trial of acute care adult admissions to a multicentered healthcare system.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700040467_abs3\"><jats:title>Methods.<\/jats:title><jats:p>CAUTIs were identified with an automated surveillance system, and device-days were measured through an electronic health record. Traditional surveillance measures of CAUTI rates per 1,000 device-days (<jats:italic>R1<\/jats:italic>) were compared with CAUTI rates per 10,000 patient-days (<jats:italic>R2<\/jats:italic>) before (T1) and after (T2) an intervention aimed at reducing catheter utilization.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700040467_abs4\"><jats:title>Results.<\/jats:title><jats:p>The device-utilization ratio declined from 0.36 to 0.28 between T1 and T2 (<jats:italic>P<\/jats:italic>&lt; .001), while infection rates were significantly lower when measured by <jats:italic>R2<\/jats:italic> (28.2 vs 23.2, <jats:italic>P<\/jats:italic> = .02). When measured by <jats:italic>R<\/jats:italic>1, however, infection rates trended upward by 6% (7.79 vs. 8.28, <jats:italic>P<\/jats:italic> = .47), and at the nursing unit level, reduction in device utilization was significantly associated with increases in infection rate.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700040467_abs5\"><jats:title>Conclusions.<\/jats:title><jats:p>The widely accepted practice of using device-days as a method of risk adjustment to calculate device-associated infection rates may mask the impact of a successful quality improvement program and reward programs not actively engaged in reducing device usage.<\/jats:p><\/jats:sec>","DOI":"10.1086\/660765","type":"journal-article","created":{"date-parts":[[2011,6,10]],"date-time":"2011-06-10T18:16:53Z","timestamp":1307729813000},"page":"635-640","source":"Crossref","is-referenced-by-count":54,"title":["Reporting Catheter-Associated Urinary Tract Infections: Denominator Matters"],"prefix":"10.1017","volume":"32","author":[{"given":"Marc-Oliver","family":"Wright","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen","family":"Kharasch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Beaumont","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lance R.","family":"Peterson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ari","family":"Robicsek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700040467_ref011","doi-asserted-by":"publisher","DOI":"10.1309\/502AUPR8VE67MBDE"},{"key":"S0195941700040467_ref003","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-6553(00)90015-4"},{"key":"S0195941700040467_ref005","doi-asserted-by":"publisher","DOI":"10.1016\/S1553-7250(09)35062-X"},{"key":"S0195941700040467_ref014","doi-asserted-by":"publisher","DOI":"10.1086\/499998"},{"key":"S0195941700040467_ref004","unstructured":"Hospital-acquired conditions (HAC) in acute inpatient prospective payment system (IPPS) hospitals. https:\/\/www.cms.gov\/HospitalAcqCond\/Downloads\/HACFactsheet.pdf Accessed November 9, 2010."},{"key":"S0195941700040467_ref008","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.11.003"},{"key":"S0195941700040467_ref013","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.21.3294"},{"key":"S0195941700040467_ref001","doi-asserted-by":"publisher","DOI":"10.1086\/650482"},{"key":"S0195941700040467_ref007","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01568-1"},{"key":"S0195941700040467_ref002","doi-asserted-by":"publisher","DOI":"10.1177\/003335490712200205"},{"key":"S0195941700040467_ref016","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2009.12.017"},{"key":"S0195941700040467_ref009","doi-asserted-by":"publisher","DOI":"10.1086\/655133"},{"key":"S0195941700040467_ref012","volume-title":"Presented at Healthcare-Associated Infections: Recovery Act Second Annual Grantee Meeting","author":"Rebmann","year":"2010"},{"key":"S0195941700040467_ref010","unstructured":"Centers for Disease Control and Prevention. The National Healthcare Safety Network (NHSN) manual. Patient safety component protocol. Division of healthcare quality promotion. http:\/\/www.cdc.gov\/ncidod\/dhqp\/pdf\/nhsn\/NHSN_Manual_PatientSafetyProtocol_CURRENT.pdf. Accessed May 11, 2010."},{"key":"S0195941700040467_ref006","doi-asserted-by":"publisher","DOI":"10.1086\/651091"},{"key":"S0195941700040467_ref015","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2004.05.002"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0195941700040467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,27]],"date-time":"2019-04-27T07:47:59Z","timestamp":1556351279000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0195941700040467\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,7]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2011,7]]}},"alternative-id":["S0195941700040467"],"URL":"https:\/\/doi.org\/10.1086\/660765","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,7]]}}}