An Algorhythmic Approach to Prevent Hospital Acquired Catheter-Associated Urinary Tract Infections

Purpose: The effects of CMS quality initiatives have been far reaching. As a result, the WOCN is frequently called upon to contribute to policy/procedure development and implement quality initiatives related to prevention of hospital-acquired catheter-associated urinary tract infections (HA-CAUTIs). Many hospitals have initiated silver-coated urinary catheters as routine for all patients requiring catheterization despite recommendations to the contrary¹ adding unnecessary costs to the cost of healthcare.

Objective: An algorhythmic approach to catheter selection for patients in acute care was developed for staff nurses using evidence-based literature^1-3 that addresses patient-specific characteristics as well as clinical decision making to appropriately and cost-effectively implement care. Additionally, a WOCN-lead multidisciplinary team teaching rounds to identify practices in use that both support and contradict the literature, allowed immediate analysis of the clinical situation, compared actual practice to the algorhythm, and facilitated appropriate practice was initiated to solidify clinical behavioral changes.

Outcomes: Evidenced based interventions to prevent HA-CAUTIs were rapidly implemented. There was with increased staff nurse clinical decision making abilities to select the most clinically appropriate urinary catheter when the algorhythm suggested that a urinary catheter was clinically indicated. There was overall decreased catheter use and silver-coated catheter was not overused, saving the facility a difference of $7.00 per patient who did not clinically need a silver-coated urinary catheter.