Developing an Efficient CAUTI Surveillance Method Using an Automated Data Collection Process

Purpose:
Traditional data collection for catheter associated urinary tract infection (CAUTI) surveillance was tedious and time-consuming. We established an interdisciplinary team that utilized an innovative IT approach to capture data efficiently in order to support quality processes.

Significance:
CAUTIs are one of the most common hospital-acquired infections (HAIs), prolonging hospital stay and increasing costs. With the need to decrease preventable HAIs, hospitals are focusing on staff education, using best practices, and creating monitoring systems to help prevent CAUTIs.

Strategy and Implementation:
After analysis of a manual process for monitoring CAUTIs in our ICU, a multidisciplinary group convened to develop a streamlined approach to CAUTI surveillance. The Nursing Informatics department evaluated the current information system and developed an automated method for counting foley catheter days from the electronic intake and output flowsheet. A daily report listing all patients with a foley catheter was scheduled for the project team that monitors the infections. A separate report was developed by Nursing Quality and Infection Control to link significant urine microbiology cultures to patients who have a recent history of a foley catheter order placed in our electronic order system. Further parameters reflecting elements of the CDC CAUTI surveillance definitions were incorporated into this report. As a result, the number of manual patient chart reviews was significantly reduced. After successful implementation in the ICU, this approach was expanded to all the inpatient units.

Evaluation:
The multidisciplinary team from Nursing Quality, Infection Control, Nursing Informatics and IT was instrumental in developing our CAUTI surveillance program. The collaborative effort made this process less complicated, improved data reliability, and reduced the time to review and report CAUTIs.

Implications for Practice:
Using advanced technology and electronic information, we were able to evaluate CAUTI in a timely manner and provide infection rates to the front line staff taking care of the patients. This information is shared with our CAUTI prevention workgroup to help guide specific prevention practices.