{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:07:32Z","timestamp":1791893252808,"version":"4.3.4"},"reference-count":21,"publisher":"AACN Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catheter-associated urinary tract infections are the second most common health care\u2013associated infections, occurring most frequently in intensive care units. These infections negatively affect patient outcomes and health care costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Local Problem<\/jats:title>\n                    <jats:p>The targeted institution for this improvement project reported 13 catheter-associated urinary tract infections in 2018, exceeding the hospital\u2019s benchmark of 4 or fewer such events annually. Six of the events occurred in the intensive care unit. Project objectives included a 30% reduction in reported catheter-associated urinary tract infections, 20% reduction in urinary catheter days, and 75% compliance rating in catheter-related documentation in the intensive care unit during the intervention phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This project used a pre-post design over 2 consecutive 4-month periods. The targeted population was critically ill patients aged 18 and older who were admitted to the intensive care unit. A set of bundled interventions was implemented, including staff education, an electronic daily checklist, and a nurse-driven removal protocol for indwelling urinary catheters. Data were analyzed using mixed statistics, including independent samples t tests and Fisher exact tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No catheter-associated urinary tract infections were reported during the intervention period, reducing the rate by 1.33 per 1000 catheter days. There was a 10.5% increase in catheter days, which was not statistically significant (P = .12). Documentation compliance increased significantly from 50.0% before to 83.3% during the intervention (P = .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This bundled approach shows promise for reducing catheter-associated urinary tract infections in critical care settings. The concept could be adapted for other health care\u2013associated infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ccn2021934","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T20:13:16Z","timestamp":1617221596000},"page":"62-71","source":"Crossref","is-referenced-by-count":25,"title":["A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit"],"prefix":"10.4037","volume":"41","author":[{"given":"Holly N.","family":"Shadle","sequence":"first","affiliation":[{"name":"Holly N. Shadle is a nurse practitioner, Neurosurgery Department, Neuroscience Center, UPMC Susquehanna, Williamsport, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Sabol","sequence":"additional","affiliation":[{"name":"Valerie Sabol is a professor and chair, Division of Healthcare in Adult Populations, Duke University School of Nursing."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Smith","sequence":"additional","affiliation":[{"name":"Amanda Smith is a clinical education specialist, Intensive Care Unit, UPMC Susquehanna."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Stafford","sequence":"additional","affiliation":[{"name":"Heather Stafford is Director of Nursing Education and Director of Infection Prevention and Control, Wound Center, Infusion Center, and Diabetes Nutrition Care Center, UPMC Susquehanna."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Julie A. Thompson is a clinical research associate and statistical consultant, Duke University School of Nursing."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Bowers","sequence":"additional","affiliation":[{"name":"Margaret Bowers is an associate professor and lead faculty cardiovascular specialty, Duke University School of Nursing."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"key":"2021040100082334600_b1-0410062","unstructured":"Agency for Healthcare Research and Quality\n          . Estimating the additional hospital inpatient cost and mortality associated with selected hospital-acquired conditions. Accessed December 20, 2019. https:\/\/www.ahrq.gov\/hai\/pfp\/haccost2017-results.html"},{"key":"2021040100082334600_b2-0410062","unstructured":"Centers for Disease Control and Prevention\n          . Data explorer (Beta). 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