'Bundles' of prevention practices best to reduce UTI rates, review finds

Using a “bundled” intervention approach has shown success in combating urinary tract infections in nursing homes, according to a recently published research review.

Researchers with the University of Michigan analyzed previous studies in order to inform future research efforts, and frontline care for residents, noting that UTIs are “one of the most common infections in nursing homes, often leading to sepsis and readmission to acute care.”

Many of the interventions shown to prevent UTIs and catheter-associated UTIs are already employed in acute-care settings, such as improving catheter care and certain infection control strategies. Other UTI-fighting strategies analyzed were specific to skilled nursing facilities, such as removing catheters upon residents' admission from the hospital and addressing incontinence issues.

Out of all the interventions analyzed as part of the review, the only one to show a significant reduction of catheter-associated UTIs was a “comprehensive program” that focused on improving antimicrobial use, hand hygiene and precautionary steps for residents with catheters.

Nursing home providers designing their own UTI “bundle” should bear in mind the challenges and resources that are unique to their care settings, researchers said. Skilled nursing operators also were advised to consider incontinence programs and discuss catheter alternatives with residents, families and staff as part of their UTI prevention strategies.

“Although catheter utilization in nursing homes is low, further reductions in catheter days and CAUTIs can be achieved,” researchers wrote.

Their findings appear in the May issue of the Journal of Hospital Medicine.