Evidence map›Paper›PMID 25111923›Full record

ArticleInfection control and hospital epidemiology2014

Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.

Charles A Baillie, Mika Epps, Asaf Hanish, Neil O Fishman, Benjamin French, Craig A Umscheid

Abstract readEvaluation Study
In one paragraph

Article in Infection control and hospital epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Charles A BaillieCenter for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Mika Epps
Asaf Hanish
Neil O Fishman
Benjamin French
Craig A Umscheid

Funding

INSTITUTIONAL CLINICAL AND TRANSLATIONAL SCIENCE AWARDUL1RR024134 · NCRR · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2006 to 2011
$70.4M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
Center For Education and Research in TherapeuticsU18HS016946 · AHRQ · UNIVERSITY OF PENNSYLVANIA · PI STROM, BRIAN LESLIE · 2007 to 2010
$4.0M
AHRQ HHS U18 HS016946AHRQ HHS U18HS016946NCATS NIH HHS UL1 TR000003NCATS NIH HHS UL1TR000003NCRR NIH HHS UL1 RR024134NCRR NIH HHS UL1RR024134
6 · The paper itself

Abstract

objectiveTo evaluate the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations.

designRetrospective cohort study.

settingAcademic healthcare system. PATIENTS: All adult patients admitted from March 2009 through May 2012.

interventionA CDS intervention was integrated into a commercial electronic health record. Providers were prompted at order entry to specify the indication for urinary catheter insertion. On the basis of the indication chosen, providers were alerted to reassess the need for the urinary catheter if it was not removed within the recommended time. Three time periods were examined: baseline, after implementation of the first intervention (stock reminder), and after a second iteration (homegrown reminder). The primary endpoint was the usability of the intervention as measured by the proportion of reminders through which providers submitted a remove urinary catheter order. Secondary endpoints were the urinary catheter utilization ratio and the rate of hospital-acquired catheter-associated urinary tract infections (CAUTIs).

resultThe first intervention displayed limited usability, with 2% of reminders resulting in a remove order. Usability improved to 15% with the revised reminder. The catheter utilization ratio declined over the 3 time periods (0.22, 0.20, and 0.19, respectively; P < .001), as did CAUTIs per 1,000 patient-days (0.84, 0.70, and 0.51, respectively; P < .001).

conclusionsA urinary catheter removal reminder system was successfully integrated within a healthcare system's electronic health record. The usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.

Indexed as

Reminder SystemsAdolescentAdultAgedAged, 80 and overCatheter-Related InfectionsCatheters, IndwellingCohort StudiesCross InfectionDecision Support Systems, ClinicalDevice RemovalElectronic Health RecordsFemaleHumansMaleMiddle Aged

Identifiers

PMID25111923
PMCPMC4575788

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.