UFOs DO EXIST: Reducing Unnecessary Foley Object

Purpose:
Catheter Associated Urinary Tract Infections (CAUTI) are the most common healthcare acquired infection in the US. The goal of our strategy was to reduce CAUTI and catheter days by implementing a theme-based educational campaign in order to meet our Partnership for Patients (PfP) CAUTI target.

Significance:
CAUTI rates at at our hospital were unacceptable, so the multi-disciplinary CAUTI Prevention Workgroup set a goal to increase awareness of CAUTI and decrease CAUTI cases by 40%. The CAUTI prevention campaign entitled “Watch Out for U.F.Os-Unnecessary Foley Objects” was launched.

Strategy and Implementation:
The elements of the campaign included investigating each and every CAUTI by conducting mini root cause analyses (RCAs), providing feedback through weekly progress reports with educational materials related to CAUTI, and creating a system where units were rewarded for substantial amounts of time without a CAUTI. The RCAs were jointly completed by Quality and Safety staff and leadership on the unit where the CAUTI were attributed. The results of these RCAs directed where further education was needed. Increased awareness of CAUTI was improved through weekly “Days Since Last CAUTI” updates and incentives were provided for 30, 185, and 365 days without a CAUTI. Any discrepancies between CAUTI prevention bundles and practice were addressed. Further education was provided hospital staff through a CAUTI prevention module and a Learning at Lunch progam.

Evaluation:
The number of CAUTIs, CAUTI rates and number of catheter days have dropped. The average number of CAUTIs went from 17 (Q1 2012) to 12 (Q1 2013). PfP data shows a 29% decrease in CAUTI rate from 2010 baseline to 2012 performance. The number of catheter days went from an average of 3300 to 3044.

Implications for Practice:
The multidisciplinary team needs to receive information in creative ways in order to change the culture and long-standing practices. Real-time reporting with frequent feedback, targeted education, and a reward system promotes healthy competition across units and engagement in CAUTI prevention.