"In most EDs, there aren't a lot of restrooms, and it takes time to go get a bedside commode. Or if staff need to get a urine specimen, they would insert an indwelling catheter so they wouldn't have to deal with it."
Krein emphasized that these were some of the issues that Michigan researchers heard from the providers they interviewed.
In the second JAMA report, the researchers surveyed 78 hospitals in Michigan and 392 in other states. They found that Michigan hospitals were more likely to have reminders or stop orders to prompt nursing staff to check daily for catheter necessity and to use bladder ultrasound testing for monitoring bladder health after catheter removal.
Likewise, comparing data collected by the Centers for Disease Control and Prevention, Michigan hospitals reduced rates of CAUTI by 25% between 2009 and 2010, while hospitals in other states reduced infections by only 6%.
Saint says that providers throughout the nation need to understand that the placement of an unnecessary urinary catheter may have other long-standing repercussions that not only can lead to poorer patient outcomes, but cost the hospital money in longer lengths of stay and lower reimbursement when CAUTI joins central line associated bloodstream infections in Medicare pay for performance initiatives.