{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T08:23:13Z","timestamp":1772871793898,"version":"3.50.1"},"reference-count":47,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>To date, there has been a shortage of evidence-based quality improvement initiatives that have shown positive outcomes in the neurosurgical patient population. A single-institution prospective intervention trial with continuous feedback was conducted to investigate the implementation of a urinary tract infection (UTI) prevention bundle to decrease the catheter-associated UTI rate.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>All patients admitted to the adult neurological intensive care unit (neuro ICU) during a 30-month period were included. The study consisted of two 1-month preintervention observation periods (approximately 1200 catheter days) followed by a 30-month intervention phase (20,394 catheter days). A comprehensive evidence-based UTI bundle encompassing avoidance of catheter insertion, maintenance of sterility, product standardization, and early catheter removal was enacted.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The urinary catheter utilization rate dropped from 100% to 73.3% during the intervention phase (p &lt; 0.0001) without any increase in the rate of sacral decubitus ulcers or other skin breakdown. The rate of catheter-associated UTI was also significantly reduced from 13.3 to 4.0 infections per 1000 catheter days (p &lt; 0.001). There was a linear relationship between the decreased quarterly catheter utilization rate and the decreased catheter-associated UTI rate (r<jats:sup>2<\/jats:sup> = 0.79, p &lt; 0.0001).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This single-center prospective study demonstrated that a comprehensive UTI prevention bundle along with a continuous quality improvement program can significantly reduce the duration of urinary catheterization and rate of catheter-associated UTI in a neuro ICU.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.11.jns11974","type":"journal-article","created":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T18:02:21Z","timestamp":1325872941000},"page":"911-920","source":"Crossref","is-referenced-by-count":65,"title":["Reduction of catheter-associated urinary tract infections among patients in a neurological intensive care unit: a single institution's success"],"prefix":"10.3171","volume":"116","author":[{"given":"W. Lee","family":"Titsworth","sequence":"first","affiliation":[{"name":"Department of Neurosurgery;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannette","family":"Hester","sequence":"additional","affiliation":[{"name":"Department of Nursing and Patient Services; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Correia","sequence":"additional","affiliation":[{"name":"Department of Nursing and Patient Services; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Nursing and Patient Services; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Infection Prevention and Control, Shands Hospital at the University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peggy","family":"Guin","sequence":"additional","affiliation":[{"name":"Department of Nursing and Patient Services; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Joseph","family":"Layon","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Anesthesiology; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennox K.","family":"Archibald","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine, University of Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Mocco","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns11974","series-title":"Arch Phys Med Rehabil","first-page":"172","article-title":"Clinical utility of a portable ultrasound device in intermittent catheterization","volume":"79","author":"Anton","year":"1998"},{"key":"b2-jns11974","series-title":"J Clin Nurs","first-page":"2098","article-title":"Silver alloy vs. uncoated urinary catheters: a systematic review of 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