CCMC CAUTI TEAM REDUCES ORGANIZATIONAL CAUTI RATE

Purpose:
Our facility had been challenged to decrease the incidence of catheter-associated urinary tract infection (CAUTI) A documented increase in rates of CAUTI had been noted organization-wide in the first quarter of 2013.

Relevance/Significance:
Preventing catheter associated urinary tract infections will improve quality and safety through the impact it will have on decreasing morbidity/mortality rates and length of stay. The utilization of evidence based practice, assessment of data has led to enhancing safety and cost reduction in delivering patient care. The clinical nurse engagement in this project led to tremendous results througout the entire organization.

Strategy and Implementation:
The CAUTI team was formed and identified primary objectives: 1) to decrease the total number of urinary catheters inserted, 2) to decrease the number of infections related to catheter insertion and maintenance, and 3)to encourage removal of catheters as soon as possible. Audits were conducted and the team found that there were variations in practice. A Root Cause Analysis tool was developed to examine care in the 48-72 hour window prior to each CAUTI. The team created the CAUTI bundle and educated clinical nurses and physicians to this bundle. The bundle included a script for daily rounds to assure the need for the catheter, promoting consistent insertion and maintenance guidelines and standardizing equipment to correlate with best practices. The team also provided this education to the perioperative specialty, as a large percent of the catheters were inserted in the operating room. Transparency of incidence of CAUTI and successes were made visible throughout the organization.

Evaluation:
The CAUTI team was indeed successful in its endeavor to decrease CAUTi within the organization. During the pre-intervention timeframe, there was an average CAUTI rate of 7.64 per 1000 catheter days. During the post-intervention timeframe, it decreased to an average CAUTI rate of 0 per 1000 catheter days. This represents a 100% decrease in the CAUTI rate to date.

Implications for Practice:
The creation of the CAUTI team and its ultimate interventions led to a significant decrease in catheter associated urinary tract infection. These practices have been disseminated thorughout the origanziaiton as well as the pediatric service line as best practices.