Karen Torres, RN, BSN, CIC: No financial relationships to disclose
Background: Catheter associated urinary tract infections (CAUTI) account for seventy to eighty percent of healthcare associated infections.
CAUTI prevention is related to appropriate use of the catheter and compliance with infection prevention bundle elements.
Through an organized approach of assessing urinary catheter appropriateness, alternative devices, and timely discontinuation, Infection Prevention partnered with nurse leaders in a daily huddle to decrease device utilization.
Methods: Infection Prevention reviewed current literature for best practices and participated on the CAUTI Reduction team. External catheters availability was confirmed. Nursing leaders and team members engagement was assessed, specifically relating to the timeliness of removal. Senior leaders were made aware.
With support of the Vice Presidents of the Medical Staff and Nursing, a daily huddle meeting with the Clinical and Senior directors was established. A computer report indicating the catheter necessity and bundle element compliance was used to prompt discussions. Clinical leaders reported out and opportunities for follow up identified. The updated report was sent to the nursing unit supervisors for follow-up with the nursing team and physicians. Escalation process was created and reinforced.
The standard utilization ration (SUR) was used to measure pre and post intervention.
Results: During the pre-intervention period of January 2020 to December 2021, the standard utilization ratio. (SUR) range was between 0.373 to 0.544. After the implementation, from January 2022 to September 2023, the SUR range was between 0.372 to 0.466. A downward trend of SUR occurred in the first through third quarters of 2023 with SUR of 0.410, 0.411, and 0.372 respectively.
Conclusions: This pilot found that having a systematic approach to assess the urinary catheter appropriateness and alternative devices facilitated the discontinuation of the catheters which lead to a decrease in the standard utilization ratio.
Engagement of our senior and clinical leaders, nursing teams, and physicians were essential to our success.
Learning Objectives:
describe the process for decreasing device utilization.
identify key partners to facilitate the process change to decrease device utilization.
describe the elements of tool used to facilitate the process change to decrease device utilization.
