Michigan Hospitals’ “Bladder Bundle” Infection Reduction

Michigan Hospitals Reduce Catheter Infection Rates

One of the most common hospital acquired infections, or nasocomial infections, is a urinary tract infection. A urinary tract infection (UTI) in the hospital setting is often caused by the use of an indwelling Foley catheter that was inserted to help a patient with emptying their bladder. One problem that the Foley catheter creates is that when the bladder is emptied, it compresses the tip of the catheter, which often causes the mucosal lining of the bladder to be vacuumed into the drainage eye of the catheter. Prolonged instances of the mucosal lining being vacuumed into the drainage eye, can either cause the mucosal lining to break, which increases the risk of infection, or it can lead to cystitis or a higher risk of bladder cancer. Any patient who is using an indwelling Foley catheter is at risk of getting a UTI simply due to the damage caused to the musocal lining of their bladder. Another reason that a patient may acquire a UTI while in the hospital is from unsterile insertion of the Foley catheter.

UTIs are responsible for a third of hospital related infections in patients. Among the catheter related UTI cases recorded in the United States, Michigan hospitals have the lowest rates according to a recent study conducted by the University of Michigan.  The reason Michigan hospitals have the lowest rates of UTI cases in the U.S. is because they are more receptive to using newer methods to prevent UTIs than other hospitals in the U.S. Data records show that Michigan’s UTI cases have dropped 25%, as compared to other state hospitals, with only a 6% drop.

Hospitals in Michigan go above and beyond to ensure that the occurrence of UTIs are prevented. They do this by practising the “Bladder Bundle” method. The “Bladder Bundle” method focuses on strict guidelines on the duration that a patient uses an indwelling catheter, the date of the stop order, the use of bladder scanners, and the proper methods used to remove indwelling catheters. Hospitals are aware how common, yet preventable, UTIs are, but fail to practice these methods in an actual hospital setting. The National Institute of Health received a 1.7 million dollar grant to find the best method to prevent UTIs and this study was published by JAMA international medicine.

The government and CMS (Centers for Medicare & Medicaid Services) are now refusing to pay hospitals for preventable illnesses such as urinary tract infections. This is in accordance to the 2008 Medicare policy and the 2008 Hospital Acquired Conditions Initiative. Due to this, the government is able to cut costs on preventable hospital infections. The Medicare policy also states that the cost of treatment for a hospital acquired UTI should not be covered by the patient, but instead, be charged at the expense of the hospital. The strictness of this policy pushes hospitals to perform their best and seek ways to prevent UTI cases from occurring.

The road to success is not always easy. There are barriers that slow progress down. The study conducted by the University of Michigan pointed out several factors for delayed development and implementation on new practices. There are 3 primary barriers: hesitancy of the medical staff to change their practices, the patient’s request for an indwelling catheter and the emergency department’s policy on the use of indwelling catheters. Each hospital has their own method of procedures and it takes time for the staff to learn and adopt new methods.

Because best practices can only go so far, it is important that hospital staff attend regular trainings and seminars to learn more about how to improve patient care and service. A  25% reduction in urinary tract infections is fantastic when compared to the industry standard, but even more can be achieved by embracing  technology and innovation. Changing the type of catheter to one that doesn't cause the level of trauma seen with a traditional indwelling Foley catheter, hasn't until recently, ever been considered. The Duette™ dual-balloon indwelling catheter is the first innovative catheter design in 75 years and independent studies show that the Duette™ is very effective in preventing damage to the mucosal wall of the bladder and therefore, helps to reduce UTIs. It has two inflatable balloons with the catheter drainage eye in between the two balloons. It’s a promising product that everyone in the medical field should seek to learn more about. Hospitals are slowly starting to acknowledge these innovative changes, but it may take some time. Advancement can only happen as medical professionals are willing to make a change. It is important for the medical team to be open minded and receptive to new methods and technology. Technology is always evolving and those in the medical field should always endeavour to keep up with the changes or get left behind.






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