The successful journey of an interdisciplinary CAUTI team as a model template for other quality improvement applications

Purpose:
This program targets the National implementation of the Comprehensive Unit–based Safety Program (CUSP) to reduce Catheter-Associated Urinary Tract Infection (CAUTI) and to decrease the use of indwelling catheters. Outcomes measured are documentation, incidence of catheter use and infection rates.

Significance:
CAUTI is the most common health care-associated infection resulting in increased healthcare cost, morbidity and mortality. CAUTI is a 2013 national patient safety goal as well as a Centers for Medicare and Medicaid never event. CAUTI should never happen and will never be paid for.

Strategy and Implementation:
A CAUTI project CHARTER was developed for the pilot. The team is comprised of nursing administration, education, clinicians, infection control, quality, and central processing. Data is collected on the incidence of indwelling catheters using a daily electronic report. The necessity for the indwelling catheter is assessed during daily discharge patient rounds in addition to nurse to physician and nurse to nurse hand off communication. Catheter-associated urinary tract infections are reported monthly by infection control and reviewed during unit meetings. The educational plan consists of a Computer Based Learning module and hands on training. Mobile learning stations were created to provide training for staff, facilitating accessibility. Nurses, assistants, transporters and therapists participated in appropriate competencies. The process discovered the need for hooks to mount on IV poles and medical imaging tables to keep catheter bag below bladder improving practice.

Evaluation:
Data was entered, compiled, and analyzed in MHA Care Counts database. Compliance with training was 100% due to the ingenuity of mobile learning stations that increased accessibility and satisfied pre-assessed learning needs. CAUTI rates for 2012 are 0 to date. Rate of catheter use has not changed.

Implications for Practice:
Project success reflects the level of staff buy-in. The process is now starting on additional units, which we hope will reproduce similar outcomes, and a reduction in catheter use. The next step will be to use this template for another quality improvement initiative to see if it is generalizable.