Significant predictors of select CAUTI, CLABSI and VAP prevention practices*
| Independent variable | Prevention practice | OR (95% CI) | P value |
| CAUTI† | |||
| Important/very important to hospital leadership to prevent urinary tract infection | Portable bladder ultrasound | 2.04 (1.17 to 3.54) | 0.01 |
| Urinary catheter reminder/stop order and/or nurse-initiated catheter discontinuation | 2.64 (1.43 to 4.88) | 0.002 | |
| Silver alloy catheters | 2.07 (1.05 to 4.09) | 0.04 | |
| Condom catheters in men | 2.93 (1.30 to 6.60) | 0.01 | |
| Presence of hospital epidemiologist | Urinary catheter reminder/stop order and/or nurse-initiated catheter discontinuation | 1.95 (1.12 to 3.39) | 0.02 |
| Routine monitoring of duration and/discontinuation of urinary catheters | Urinary catheter reminder/stop order and/or nurse-initiated catheter discontinuation | 3.35 (1.61 to 6.96) | 0.001 |
| Aseptic technique during catheter insertion and maintenance | 2.85 (1.28 to 6.36) | 0.01 | |
| Intermittent catheterisation | 2.32 (1.23 to 4.38) | 0.01 | |
| Lead infection preventionist certified in infection control | Condom catheters in men | 2.00 (1.14 to 3.49) | 0.02 |
| Very good/excellent overall support of infection prevention and control programme from hospital leadership | Aseptic technique during catheter insertion and maintenance | 2.25 (1.16 to 4.36) | 0.02 |
| Routine urine test to screen for urinary tract infection at hospital admission | Aseptic technique during catheter insertion and maintenance | 5.05 (1.53 to 16.6) | 0.01 |
| CLABSI‡ | |||
| Involved in collaborative effort to reduce healthcare-associated infections | Maximum sterile barrier precautions during central catheter insertion | 3.16 (1.06 to 9.46) | 0.04 |
| Important/very important to hospital leadership to prevent central catheter infection | Maximum sterile barrier precautions during central catheter insertion | 4.24 (1.28 to 14.05) | 0.02 |
| Lead infection preventionist certified in infection control | Antimicrobial catheters | 0.50 (0.32 to 0.76) | 0.001 |
| Hospital affiliated with medical school | Antimicrobial dressing with chlorhexidine | 0.38 (0.21 to 0.70) | 0.002 |
| Very good/excellent overall support of infection prevention and control programme from hospital leadership | Antimicrobial dressing with chlorhexidine | 1.79 (1.01 to 3.18) | 0.05 |
| Daily rounds to assess ongoing necessity of peripherally inserted central catheters | Use of midline catheters instead of central venous catheters | 2.19 (1.40 to 3.45) | 0.001 |
| VAP§ | |||
| Involved in collaborative effort to reduce healthcare-associated infections | Antimicrobial mouth rinse | 2.21 (1.24 to 3.93) | 0.01 |
| Lead infection preventionist certified in infection control | Antimicrobial mouth rinse | 1.95 (1.14 to 3.31) | 0.01 |
| ‘Sedation vacation’ | 1.90 (1.09 to 3.31) | 0.03 | |
| Important/very important to hospital leadership to prevent ventilator-associated pneumonia | Antimicrobial mouth rinse | 2.10 (1.17 to 3.75) | 0.01 |
| Subglottic secretion drainage | 1.73 (1.08 to 2.78) | 0.02 | |
| Topical and/or systemic antibiotics for selective digestive tract decontamination | 2.31 (1.27 to 4.20) | 0.01 | |
| Very good/excellent overall support of infection prevention and control programme from hospital leadership | Topical and/or systemic antibiotics for selective digestive tract decontamination | 0.53 (0.33 to 0.85) | 0.01 |
| Encourage early mobilisation of ventilated patients | Silver-coated endotracheal tubes | 6.52 (1.48 to 28.77) | 0.01 |
*All multivariable logistic regression models were adjusted for total number of adult acute care or ICU beds, medical school affiliation, involvement in HAI collaborative, overall support for infection control programme from hospital leadership, presence of a hospital epidemiologist and whether the lead infection preventionist is certified in infection control. Other domain-specific independent variables (eg, perception of how important it is to hospital leadership to prevent CAUTI, CLABSI or VAP, and various CAUTI, CLABSI and VAP surveillance measures) were included within multivariable models if significant in bivariable analyses.
†Sample sizes for CAUTI prevention practices were as follows: portable bladder ultrasound=476, urinary catheter reminder/stop order and/or nurse-initiated catheter discontinuation=469, silver alloy catheters=467, condom catheters in men=465, aseptic technique during catheter insertion and maintenance=469, intermittent catheterisation=469.
‡Sample sizes for CLABSI prevention practices were as follows: maximum sterile barrier precautions during central catheter insertion=476, antimicrobial catheters=466, antimicrobial dressing with chlorhexidine=481, use of midline catheters instead of central venous catheters=473.
§Sample sizes for VAP prevention practices were as follows: antimicrobial mouth rinse=449, ‘Sedation vacation’=449, subglottic secretion drainage=431, topical and/or systemic antibiotics for selective digestive tract decontamination=433, silver-coated endotracheal tubes=427.
CAUTI, catheter-associated urinary tract infection; CLABSI, central line-associated bloodstream infection; VAP, ventilator-associated pneumonia.