QAPI 122 - Comprehensive Intervention Strategies for the Reduction of Hospital-acquired Urinary Tract Infections in Pediatric Spinal Cord Injury Patients

Background: Hospital-acquired urinary tract infections (HAUTIs) lead to decreased quality of care and patient outcomes. This process improvement project addresses an increase in hospital-acquired urinary tract infections (HAUTIs) within a Louisiana-based pediatric health center from 2019 to 2022. In response, urinary tract infection criteria were redefined to enhance inclusivity for Spinal Cord Injury (SCI) patients in comparison to national reporting agencies. The utilization of a more sensitive tool facilitated a comprehensive root cause analysis, identifying the SCI rehabilitation program as a significant contributor.

Methods: We conducted a pre- and post-intervention analysis of a catheter insertion bundle. This bundle comprised a catheter checklist and a closed system catheter set. The catheter checklist aimed to standardize and enhance adherence to infection prevention protocols during catheterization, while the closed system catheter set aimed to minimize the risk of microbial contamination.

Results: Implemented at the beginning of quarter three of 2023 , the intervention resulted in a 60% reduction in HAUTIs among pediatric SCI patients within the first quarter of implementation when compared to the pre-intervention period. No HAUTIs were reported during the first two months of quarter four.

Conclusions: The reduction in HAUTIs through a catheter checklist and closed system catheter set underscores their efficacy in improving patient outcomes. This success emphasizes the need for tailored prevention in specialized settings like SCI rehabilitation, offering potential for broader implementation across healthcare settings. The imperative for infection preventionists to address infections beyond national reporting requirements is crucial for addressing emerging challenges in patient safety.