About the Toolkit Development
The toolkit was developed based on the experiences of approximately 500 nursing homes across the country that participated in the AHRQ Safety Program for Long-Term Care: HAIs/CAUTI, a 3-year implementation project to reduce CAUTI and other HAIs while enhancing patient safety culture. Overall, the nursing homes that participated in this project lowered CAUTI by 47 percent (results are described further in the final report). This project was funded by the Agency for Healthcare Research and Quality and is part of the U.S. Department of Health & Human Services National Action Plan to Prevent Healthcare-associated Infections.1
To help other nursing homes reduce their rates of CAUTI, AHRQ developed this toolkit, which includes the resources used by nursing homes who participated in the implementation project. Tools and resources in this toolkit promote evidence-based practices and apply AHRQ's Comprehensive Unit-based Safety Program (CUSP) specifically for the long-term care setting.
The implementation project and toolkit were funded by the Agency for Healthcare Research and Quality and is part of the U.S. Department of Health & Human Services National Action Plan to Prevent Healthcare-associated Infections.2
Infections that develop in health care settings are known as HAIs. HAIs are especially significant in LTC settings, as they have been estimated to account for 1.6 million to 3.8 million infections and 388,000 deaths annually.3 Additionally, infections have very high costs to LTC facilities: $38 million to $137 million annually for antimicrobial therapy and $673 million to $2 billion for hospitalizations.4 CAUTI is a common, costly, and potentially life-threatening HAI for LTC residents. An estimated 7 to 10 percent5 of all LTC residents have urinary catheters, including 12 percent6 of all new admissions at the time of transfer from acute care facilities to LTC facilities.
This project brought together subject matter experts from partner organizations and participating LTC facilities across the country to inform, learn, and adapt to the unique needs of the LTC environment.
The national project team included—
- Health Research & Educational Trust, an affiliate of the American Hospital Association
- University of Michigan
- Abt Associates
- Association of Professionals in Infection Control and Epidemiology
- Baylor College of Medicine
- Society of Hospital Medicine
1HHS National Action Plan to Prevent Health-care Associated Infections: Road Map to Elimination. Web-based guide. April 2013. U.S. Department of Health & Human Services. https://health.gov/hcq/prevent-hai-action-plan.asp. Accessed August 18, 2015.
2HHS National Action Plan to Prevent Health-care Associated Infections: Road Map to Elimination. Web-based guide. April 2013. U.S. Department of Health & Human Services. https://health.gov/hcq/prevent-hai-action-plan.asp. Accessed August 18, 2015.
3Richards CL. Infections in residents of long-term care facilities: an agenda for research. Report of an expert panel. J Am Geriatr Soc. 2002;50:570-6. PMID: 11943058.
4Wagner, LM., Roup, B.J., Castle, NG. Impact of infection preventionists on Centers for Medicare and Medicaid quality measures in Maryland nursing homes. Am J Infect Control. 2014; Jan 42(1): 2-6. PMID: 24388467.
5Smith PW, Bennett G, Bradley SF, et al. SHEA/APIC Guideline: Infection prevention and control in the long-term care facility. Infect Control Hosp Epidemiol. 2008; 29:785–814. PMID: 18786461.
6Mody L, Bradley SF, Galecki A, et al. Conceptual model for reducing infections and antimicrobial resistance in skilled nursing facilities: focus on residents with indwelling devices. Clin Infect Dis. 2011;52:654-61. PMID: 21292670.