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. 2023 Dec;44(12):1913-1919.
doi: 10.1017/ice.2023.65. Epub 2023 Jun 1.

What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States

Sanjay Saint  1   2   3 , M Todd Greene  1   2   3 , Sarah L Krein  1   2   3 , Karen E Fowler  1   3 , Kathleen A Linder  2   3   4 , David Ratz  1   3 , Jennifer Meddings  1   2   3   5
Affiliations

What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States

Sanjay Saint et al. Infect Control Hosp Epidemiol. 2023 Dec.

Abstract

Objective: The ways that device-associated infection prevention practices changed during the coronavirus disease 2019 (COVID-19) pandemic remain unknown. We collected data mid-pandemic to assess the use of several infection prevention practices and for comparison with historical data.

Design: Repeated cross-sectional survey.

Setting: US acute-care hospitals.

Participants: Infection preventionists.

Methods: We surveyed infection preventionists from a national random sample of 881 US acute-care hospitals in 2021 to estimate the current use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated events (VAE). We compared the 2021 results with those from surveys occurring every 4 years since 2005.

Results: The 2021 survey response rate was 47%; previous survey response rates ranged from 59% to 72%. Regular use of most practices to prevent CLABSI (chlorhexidine gluconate for site antisepsis, 99.0%, and maximum sterile barrier precautions, 98.7%) and VAE (semirecumbent positioning, 93.4%, and sedation vacation, 85.8%) continued to increase or plateaued in 2021. Conversely, use of several CAUTI prevention practices (portable bladder ultrasound scanner, 65.6%; catheter reminders or nurse-initiated discontinuation, 66.3%; and intermittent catheterization, 37.3%) was lower in 2021, with a significant decrease for some practices compared to 2017 (P ≤ .02 for all comparisons). In 2021, 42.1% of hospitals reported regular use of the newer external urinary collection devices for women.

Conclusions: Although regular use of CLABSI and VAE preventive practices continued to increase (or plateaued), use of several CAUTI preventive practices decreased during the COVID-19 pandemic. Structural issues relating to care during the pandemic may have contributed to a decrease in device-associated infection prevention practices.

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Conflict of interest statement

Dr. Saint reports personal fees related to CAUTI prevention and serving on medical advisory boards of Doximity and Jvion, outside the submitted work. Dr. Meddings reports personal fees related to prevention of and value-based policies involving CAUTI and hospital-acquired pressure sores, outside the submitted work. Drs. Saint and Meddings are listed as inventors on US patent no. 10279145, a catheter-placement assist device that was not used in this study. All other authors report no financial conflicts of interest.

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