Conference Year

2016

Hospital/Entity

Baptist Hospital

Category of Abstract

Evidence Based Practice

Presentation Title

Initiatives to Reduce Catheter-Associated Urinary Tract Infections

Abstract

Background: The Critical Care Unit at Baptist Hospital in Miami, Florida has the greatest number of CAUTI because patients who are admitted to the unit have a higher incidence of indwelling catheter insertions due to the high patient acuity. A proposed clinical protocol bundle will help to decrease the CAUTI rate, improve patient outcomes, decrease mortality rates, decrease cost, and improve patient safety.

Methods: Recommendations from the Centers for Disease Control and Prevention (CDC) were utilized for this performance improvement initiative as a CAUTI prevention bundle. The following strategies were educated to the Critical Care staff and initiated: proper hand hygiene; appropriate and inappropriate use for indwelling catheters; prevention of unnecessary insertion; limiting duration of catheter use; aseptic and closed catheter systems; proper perineal hygiene; elimination of bed basins; proper chlorhexidine bathing; the importance of documentation; alternatives to indwelling catheters; team care; CAUTI treatment; and initiatives to reduce cost. With education, creation of CAUTI prevention champions, unit Infection Control Committee, an interdisciplinary approach including a physician champion, monitoring for compliance, weekly audits, and feedback from the staff, the positive outcomes demonstrate a decrease in the Critical Care CAUTI rate.

Results: Data was collected from the Critical Care Unit’s past fiscal years to compare old data to new data. The benchmark for Critical Care for the National Healthcare Safety Network (NHSN) is 1.4 per 1,000 catheter days. The goal for the Critical Care Unit has been to be below the national benchmark, with a rate of zero CAUTI. The Critical Care Unit has decreased the CAUTI rate by 83% from fiscal year (FY) 2010 to FY 2015 which was a rate of 8.8 to 1.5 per 1,000 catheter days. The Critical Care Unit has completed the first quarter of FY 2016 below benchmark at 0.6 per 1,000 catheter days which is a 60% reduction.

Objective of Presentation

(1) Develop an updated CAUTI policy based on EBP guidelines, research, and APIC’s recommendations. (2) Apply safe, timely, effective, efficient, equitable, and patient centered care within a collaborative approach with highly skilled teams to improve the quality of care delivery and prevent CAUTI. (3) Guide, educate, mentor, and lead teams in the area of improved patient outcomes and patient safety by reducing the CAUTI rate.

Summary of Presentation

The success of the CAUTI prevention bundle relieves the patient of the cost of illness, further illness, psychosocial issues, and pain and stress that can arise from catheter associated urinary infections. The Critical Care unit’s role in achieving the strategic plan is demonstrated by creating an environment contributing to innovation, multidisciplinary collaboration, planning, implementation, ongoing learning, and enhanced professional practice and evaluation. All these components are essential to providing continuity, quality, and service excellence.

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Initiatives to Reduce Catheter-Associated Urinary Tract Infections

Background: The Critical Care Unit at Baptist Hospital in Miami, Florida has the greatest number of CAUTI because patients who are admitted to the unit have a higher incidence of indwelling catheter insertions due to the high patient acuity. A proposed clinical protocol bundle will help to decrease the CAUTI rate, improve patient outcomes, decrease mortality rates, decrease cost, and improve patient safety.

Methods: Recommendations from the Centers for Disease Control and Prevention (CDC) were utilized for this performance improvement initiative as a CAUTI prevention bundle. The following strategies were educated to the Critical Care staff and initiated: proper hand hygiene; appropriate and inappropriate use for indwelling catheters; prevention of unnecessary insertion; limiting duration of catheter use; aseptic and closed catheter systems; proper perineal hygiene; elimination of bed basins; proper chlorhexidine bathing; the importance of documentation; alternatives to indwelling catheters; team care; CAUTI treatment; and initiatives to reduce cost. With education, creation of CAUTI prevention champions, unit Infection Control Committee, an interdisciplinary approach including a physician champion, monitoring for compliance, weekly audits, and feedback from the staff, the positive outcomes demonstrate a decrease in the Critical Care CAUTI rate.

Results: Data was collected from the Critical Care Unit’s past fiscal years to compare old data to new data. The benchmark for Critical Care for the National Healthcare Safety Network (NHSN) is 1.4 per 1,000 catheter days. The goal for the Critical Care Unit has been to be below the national benchmark, with a rate of zero CAUTI. The Critical Care Unit has decreased the CAUTI rate by 83% from fiscal year (FY) 2010 to FY 2015 which was a rate of 8.8 to 1.5 per 1,000 catheter days. The Critical Care Unit has completed the first quarter of FY 2016 below benchmark at 0.6 per 1,000 catheter days which is a 60% reduction.