Simplified EHR Cuts Instances Of Infection
By Katie Wike, contributing writer
By using a simpler version of electronic health record, hospitals may be able to prevent the majority of infections from catheterization.
A recent study published by JSTOR says electronic health records (EHRs) have to potential to reduce urinary tract infections in hospitalized patients. The authors of the study - Usability and Impact of a Computerized Clinical Decision Support Intervention Designed to Reduce Urinary Catheter Utilization and Catheter-Associated Urinary Tract Infections - write, “Virtually all healthcare associated UTIs are caused by instrumentation of the urinary tract. Catheter-associated UTIs (CAUTIs) have been associated with increased morbidity, mortality, hospital cost, and length of stay.”
“Catheterization can be an essential part of patient care. However in many cases, catheters are placed for inappropriate indications and healthcare providers are often unaware that their patients have catheters, leading to prolonged and unnecessary use.”
iHealth Beat explains that 75 percent of hospital acquired UTIs are associated with catheterization. Up to 70 percent of these infections could be prevented by simply removing catheters that are no longer needed.
For the study, conducted by the University of Pennsylvania, healthcare providers were required to enter a reason for catheterization into the EHR. Then, when the end of the recommended catheterization time was up, an alert was triggered to remind providers to remove or reevaluate the catheter. During the first phase of the study, they were alerted through the standard EHR. During the second phase of the study, they were notified through a simplified alert that required less mouse clicks.
Researchers found that for the first phase of the study, 2 percent of catheters were removed following the alert. This reduced UTIs from .84 per 1,000 patients to .70 per 1,000 patients. In the second phase of the study, 15 percent of unnecessary catheters were removed, further reducing the infection rate to .50 per 1,000 patients.
“Our study has two crucial, applicable findings,” said the Penn study’s lead author Charles A. Baillie, MD, an internal medicine specialist and fellow in the Center for Clinical Epidemiology and Biostatistics at Penn Medicine, according to EHR Intelligence.
“First, electronic alerts do result in fewer catheter-associated urinary tract infections. Second, the design of the alerts is very important. By making the alert quicker and easier to use, we saw a dramatic increase in the number of catheters removed in patients who no longer needed them. Fewer catheters means fewer infections, fewer days in the hospital, and even, fewer deaths. Not to mention the dollars saved by the health system in general.”