Assessing the Effectiveness of Multidisciplinary Interventions in Reducing Catheter-Associated Urinary Tract Infection: An Interrupted Time Series Modeling Approach

Background: Recommendations support multi-interventional catheter-associated urinary tract infection (CAUTI) reduction programs; however, identifying specific interventions with significant impact may be beneficial in resource-limited settings. Purpose: To determine which intervention(s) were most effective at reducing CAUTI Standardized Infection Ratio (SIR) and urinary catheter utilization. Methods: Interventions were implemented from September 2020 to February 2023, including Clinical Quality rounds, silicone to latex urinary catheter transition, nurse-driven removal protocol revision, and updated urinalysis with reflex process. To determine effectiveness, institutional data on SIR were modeled over time using an autoregressive integrated moving average time series model, observing the change in outcome when adopting each intervention. Results: There was no clinically meaningful effect of singular interventions on the SIR. Implementing multiple interventions over time reduced SIR significantly when compared with the time before the interventions ( P = .032). Conclusions: This empirical evidence demonstrates that a combination of targeted, multidisciplinary strategies may be most effective in reducing CAUTI.