Publication Title

Presented at Providence Holy Family, Spokane, Washington

Document Type

Presentation

Publication Date

2024

Keywords

washington; spokane; holy family

Abstract

Abstract Title: A Quality Improvement Project to Reduce CAUTIs on Inpatient Units

Objectives:

  1. Participants will be able to understand how interprofessional collaboration contributed to CAUTI reduction on inpatient acute care units.
  2. Participants will be able to understand education nurses completed to reduce CAUTI rates on inpatient acute care units.

Purpose/Aims:

To reduce CAUTI rates for adult inpatients admitted to the acute care units: Progressive Care Unit (PCU), Surgical/Orthopedics, Medical/Oncology, and the Intensive Care Unit (ICU).

Background

An increase in CAUTI rates for adults admitted to inpatient units was identified in January of 2024. The CAUTI rate at that time was 3.41 per 1,000 catheter days. This rate was above the National Database of Nurse Sensitive Quality Indicators (NDNQI) benchmarks.

Catheter Associated Urinary Tract Infection (CAUTIs) are associated with increased morbidity, mortality, healthcare costs, and length of stay (CDC, n.d.)

Multidisciplinary teams with varied interventions have been successful at reduced CAUTI rates (Whitaker et al. 2023).

Methods/Approach:

Key stakeholders were identified and a group called Guardian’s of the Catheters (GOC) was formed. This interdisciplinary group included clinical nurses, nursing management, infection prevention, professional development, an internal medicine physician, and partners from the local Washington State University nursing school including the bachelors of science in nursing program director and a honors nursing student. The group had multiple meetings and conducted a literature review focused on best practices for catheter infection prevention and determined a plan for implementing nursing education and nursing assistant catheter care skills check offs aimed at reducing CAUTI rates for inpatients who required a catheter.

The interprofessional COG working group created evidence-based educational binders for each unit and included a pre and post learning quiz to enhance learning objectives. All nurses aides on each unit were asked to demonstrate proper catheter care and were signed off by a registered nurse after completion. Education focused on surveillance versus medical definitions for hospitalists and surgical providers. Clinical nurse champions were recruited, and education focused on best-practices and encouragement of early catheter removal using the established nurse driven protocol.

Results/Outcomes:

Project implementation occurred in March of 2024 and with continued education through July 2024. The combined acute care units saw a rate reduction to 0.0 for the months of April to July 2024. Final data will be presented through September 2024.

Conclusions/Implications:

Inpatient units reduced the rate of CAUTIs among those with indwelling foley catheters with the GOC interprofessional team. Consider a multidisciplinary approach and nurse champions to reduce and sustain preventable CAUTIs on inpatient units. This work brought significant awareness and clinical nurse advocacy as to why early catheter removal is necessary, clinical indicators for use, and helped to educate families on this process.

References

Centers for Disease Control [CDC] (n.d.). Urinary Tract Infection. Retrieved October 9, 2024, from https://www.cdc.gov/uti/about/cauti-basics.html

Whitaker, A., Colgrove, G., Scheutzow, M., Ramic, M., & Monaco, K., Hill, J.L. (2023). Decreasing catheter-associated urinary tract infection (CAUTI) at a community academic medical center using a multidisciplinary team employing a multi-pronged approach during the COVID-19 pandemic. American Journal of Infection Control. 51(3):319-323. doi: 10.1016/j.ajic.2022.08.006.

Specialty/Research Institute

Nursing

Specialty/Research Institute

Infectious Diseases

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