A retrospective evaluation of a health provider electronic health record reminder system to reduce urinary tract infections through enhanced barrier precautions in a skilled nursing facility

Abstract

Background

Urinary tract infections (UTIs) caused by multidrug-resistant organisms (MDROs) are a significant concern in skilled nursing facilities (SNFs). Despite the effectiveness of enhanced barrier precautions (EBP) in preventing MDRO transmission, their implementation is often inconsistent in SNFs.

Methods

For this quality improvement initiative, an electronic health record (EHR) reminder system was implemented, along with staff education and regular audits, to increase compliance with EBP practices.

Results

MDRO-associated UTIs significantly decreased from 41.49% to 9.36% (p < 0.0001). Nurse compliance with EBP throughout the intervention period ranged from 91.94 to 99.38%.

Conclusions

Findings highlight the effectiveness of a multifaceted infection prevention approach, emphasizing the importance of combining technology, staff training, and regular audits to improve infection control practices.

Keywords

urinary tract infections multidrug-resistant organisms skilled nursing facility enhanced barrier precautions infection prevention electronic health record

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References

Centers for Disease Control and Prevention (2024) Implementation of personal protective equipment (PPE) use in nursing homes to prevent spread of multidrug-resistant organisms (MDROs). Available at. https://www.cdc.gov/long-term-care-facilities/hcp/prevent-mdro/ppe.html (Accessed 7 October 2023).

Centers for Disease Control and Prevention (2025) Surveillance Definitions for Specific Types of Infections: Urinary Tract Infection (UTI) Events (NHSN Patient Safety Manual, Chapter 17). U.S. Department of Health and Human Services.

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