"If you find yourself hospitalized youve got a one in five chance of needing a urinary catheter  raising your risk for a urinary tract infection. Now researchers report that a new program shows it might be possible to reduce both catheter use and its associated infections. Catheterassociated urinary tract infections are common and costly patient safety problems said lead researcher Dr. Sanjay Saint. He is a professor of internal medicine at the University of Michigan in Ann Arbor. Roughly  such infections occur in hospitals each year in the United States costing about  million the researchers pointed out. Although about  percent of hospitalized patients get a urinary catheter onethird of the time they arent needed Saint said. He believes that patients can play a role in reducing catheter use. A lot of patients and families dont realize that there are problems with a urinary catheter so they may request them because they think it will allow patients to stay in bed Saint said.  Unfortunately there are side effects with a catheter. And Ive seen patients who have gotten up in the middle of the night and they trip and fall on the tubing he explained. Patients and families should request that a catheter not be put in and if there is one there the patient should ask every day whether it is still needed Saint suggested. For the study Saint and his colleagues tried the new program in  hospitals.  After  months of using the program infection rates among hospital patients in general wards dropped by onethird while catheter use had dropped about  percent. But there was no drop in infections or catheter use in intensive care units ICUs the study findings showed. Hospitalacquired urinary tract infection rates rose nationwide during the same time period Saint noted. The program Saint helped develop  called the bladder bundle  includes protocols checklists training and informationsharing that help doctors and nurses reduce catheter use and prevent infections.  Included in the program are  Daily checks to see if a catheter is still needed.  Using other options to collect urine such as bedpans.  Training for managing urinary catheters.  Use of infectioncontrol techniques for catheter placement and maintenance.  Feedback to the medical team about catheter use and infection rates. The researchers found that catheter infection rates in the new program dropped  percent overall in general wards nonICU. The findings were published June  in the New England Journal of Medicine. Dr. Susan Huang a professor of infectious disease at the University of California Irvine wrote an editorial accompanying the study. She said While weve known the correct care processes for managing urinary catheters we havent been able to reliably reduce catheterrelated infections.  An intervention that focuses on changing the culture in hospitals to make them more responsive to the problem of infection control  one that involves rallying around a focused problem and ensuring teambased solutions  is integral to improving infection control in hospitals she said. As for improving infection control in intensive care units Huang said further analysis may help us understand why this intervention didnt work. This program can reduce urinary infections in hospitals if a team is assembled to ensure adoption of best practices and to rapidly correct reasons for failing to comply with these processes she added. More information Visit the U.S. Centers for Disease Control and Prevention http_utiuti.html for more on urinary tract infections. SOURCES Sanjay Saint M.D. M.P.H. professor internal medicine University of Michigan Ann Arbor Susan Huang M.D. M.P.H. professor infectious disease University of California Irvine June   New England Journal of Medicine"