Reducing CaUTI with Best Practices

Ann K Taylor, MS, RN, CWOCN, Spalding Regional Hospital, Griffin, GA

Purpose:
To identify nursing practice prior to implementation of evidence based interventions to reduce Catheter Acquired Urinary Tract Infections (CAUTI) hospitalwide.

Significance:
CAUTIs are the most common type of healthcare acquired infection reported by acute care hospitals. This is associated with undesirable outcomes for patients and facilities. Infection prevention measures and nursing practice may impact the prevention of this condition.

Strategy and Implementation:
Utilizing sales partners, a Foley practice survey was done in the building that identified our areas for improvement for Foley catheter practices. The issues identified were insertion technique, Foley indications and nursing maintenance of the catheter once inserted. Our Foley supply kit was changed to facilitate best practices for insertion in terms of aseptic technique. Ki t labeling allowed a visual confirmation of when catheter was inserted and a reason for insertion. During the supply change education we included indications for Foley insertion and nursing practices for maintaining the catheter until removal. We implemented a quarterly prevalence study for number of catheters; maintenance practice; compliance with labeling and reasons for insertions to enable continued Foley practice evaluation.

Evaluation:
Our Hospital reduced ICU CAUTI rate to zero for the 6 month period after implementation and had  infection in the whole facilty reduced by 47% in the  12 month calendar year of implementation. Prevalence showed marked improvement in maintenance of the catheters and education needs were identified in documentation of the reasons for insertion and timely removal of medically (not surgically) placed catheters.

Implications for Practice:
Basic CAUTI interventions were simplified with results noted in decrease in reported CAUTIs. Patient complications were reduced. Costs were maintained as practice was the change agent. Ongoing monitoring of practice and follow up education is indicated to keep CAUTI rates trending toward goal of zero.