Use of Castile Soap for Indwelling Urinary Catheter Care One Units Success Story in the Fight Against CAUTI
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The purpose of this project was to develop a consistent effective way to provide indwelling urinary catheter (IUC) care. The goal was to decrease incidence of catheter associated urinary tract infections (CAUTI) in a surgical intensive care unit (SICU).
Relevance/Significance:
There were barriers to IUC care in the SICU that were contributing to the CAUTI rate. These barriers included a lack of a convenient, cost effective product and a consistent IUC care regimen. CAUTI can increase a patient's length of stay with an increased cost of $0.4-0.5 billion per year nationally. The Center for Medicare and Medicaid Services (CMS) no longer reimburses for CAUTI and beginning in 2015, poorly performing hospitals are being penalized for certain HAI such as CAUTI.
Strategy and Implementation:
All staff nurses and patient care technicians were educated individually on the project. Education included the appropriate technique to use when doing IUC care using the Castile soap products. Members of the interdisciplinary team were also educated and newsletters describing the project were distributed to everyone. A supply of Castile soap, along with a tip sheet on providing catheter care was kept on the counter of each patient's room. Keeping the product in view serves as a reminder to perform catheter care and refill the supply. The unit's clinical nurse specialist monitored the progress on the process regularly and reeducates staff as necessary on the appropriate use of the castile soap products.
Evaluation:
The unit CAUTI rate prior to implementation of the standardized castile soap IUC care regimen was 6.18 infections per 1000 catheter days. The post intervention CAUTI rate was 4.21 infections per 1000 catheter days just above the National Healthcare Surveillance Network (NHSN) target of 4.1. This was a 32% reduction in infections for the unit over a three year period.
Implications for Practice:
The use of castile soap and having a standardized regimen for IUC care led to increased staff satisfaction and raised awareness of the importance of IUC care. Since the implementation of this project several other units have successfully adopted the use of castile soap products for IUC care.