Chasing Zero in Critical Care

Purpose:
This project is done as an effort to bring the Catheter Associated Urinary Tract Infection (CAUTI) rate to zero, not to “out-perform” the benchmark. In 2014 the CAUTI rate of critical care unit was at 5.26 per thousand device days compared to a national benchmark at 2.05 per thousand device days.

Relevance/Significance:
This project used evidence-based interventions to bring the CAUTI rate to zero which out performs the benchmark.

Strategy and Implementation:
The stretch goal is zero CAUTI per 1000 device days for at least 4 consecutive months and ongoing. Rapid cycle performance improvement (PI) including PDCA and a TRIM project were done in an effort to prevent urinary tract infections (UTI) being acquired while in the hospital. (TRIM is our Lean methodology.)Using Evidence-based practices such as discontinuing basin baths, improving hand hygiene, obtaining 14 FR indwelling urinary catheters (IUC), changing to RN only insertions, adding an ARNP to Critical Care, instituting a nurse-driven standard of care, and increasing peri-care to two times per shift with a silver impregnated cloth.

Evaluation:
The success of CAUTI prevention has been two months of decline in CAUTI rate and 4 months at zero.

Implications for Practice:
Since these practices are working in Critical Care, the plan is to roll-out these interventions to the Medical and Surgical areas of the hospital.