# Enhancing Patient Safety by Preventing Urinary Tract Infection in Post-Acute Care

> **NIH AHRQ R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $464,283

## Abstract

ABSTRACT
Over 1.4 million people currently reside in a U.S. nursing home (NH) with 2 million new admissions each year.
NHs are crucial for meeting short and long-term care needs of older adults. With the burgeoning post-acute
care population, many of these individuals are recovering from serious events and are at high risk of
complications, including healthcare-associated infections. In fact, nearly 25% of the post-acute population
returns to a hospital with an infection, accounting for 325,000 hospital transfers and over $4 billion in
additional healthcare costs per year in the U.S. Robust prevention programs in NHs are therefore critical to
prevent infections, reduce unnecessary antimicrobial use, reduce transmission of multidrug-resistant
organisms, and enhance patient safety. However, NHs face special challenges in implementing an effective
infection prevention program, including limited resources, diagnostic challenges in a frail functionally disabled
long-stay population, and an unacceptably high prevalence of multidrug-resistant organisms. A model that
integrates NH infection prevention initiatives with hospital infection prevention programs within an
Accountable Care Organization framework has the potential to improve continuity and quality of care, reduce
infection, inappropriate transfers, and the spread of antimicrobial resistance. With this proposal, our goals are
to first develop and evaluate an integrated model using 3 healthcare systems including 3 major hospitals and 15
community-based NHs. Then, using a stepped-wedge cluster randomized trial design, we propose to test the
effectiveness of an integrated UTI prevention program in reducing catheter-associated and non-catheter-
associated UTIs, inappropriate antibiotic use in patients with asymptomatic bacteriuria, and UTI-related
hospitalizations. We will achieve these goals through the following aims. Specific Aim 1: Develop an
integrated model of hospital and NH infection prevention using UTI (catheter and non-catheter-associated)
prevention and management as an exemplar, and pilot this model in 15 NHs and 3 referral hospitals. We will
adapt existing tools, materials, resources and finalize study protocols. In particular, we will emphasize targeted
collaborations and knowledge transfer pertaining to asymptomatic bacteriuria, use of diagnostic testing to
detect infection, defining UTI using standardized criteria, and treatment decisions. Specific Aim 2: Using a
stepped-wedge cluster randomized trial design, we will test an integrated infection prevention model in
preventing all catheter and non-catheter-associated UTIs in 60 NHs. Specific Aim 2a: Evaluate provider and
leadership satisfaction with the integrated infection prevention model, using qualitative and quantitative
methods. Specific Aim 2b: Evaluate the impact of the integrated infection prevention model on other NHSN
reportable outcomes and process measures (e.g., positive cultures for methicillin-resistant Staphylococcus
...

## Key facts

- **NIH application ID:** 10165786
- **Project number:** 5R01HS025451-05
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Lona Mody
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $464,283
- **Award type:** 5
- **Project period:** 2017-08-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10165786

## Citation

> US National Institutes of Health, RePORTER application 10165786, Enhancing Patient Safety by Preventing Urinary Tract Infection in Post-Acute Care (5R01HS025451-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10165786. Licensed CC0.

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