Infection Prevention in conjunction with the CAUTI (Catheter Associated Urinary Tract Infection) Team and CLABSI (Central Line Associated Blood Stream Infection) VAT (Vascular Access Team) Committee implemented a new initiative called Eyes on the Lines to decrease indwelling urinary catheters and high-risk central lines and reduce the risk of device associated infections. The project included bi-monthly foley catheter audits and routine review of reports to identify patients that may qualify for removal of unnecessary urinary catheters or high-risk central lines, resulting in a reduction in central line device utilization and catheter associated urinary tract infections hospital wide.
Problem: The Eyes on the Lines project was initially implemented by the CAUTI Team in response to an upward trend of 7 data points in indwelling urinary catheter device utilization. The project was adopted by the CLABSI VAT Committee with a baseline median central line device utilization ratio of 143.82
Measurement:Run charts with a median were used to identify statistically significant shifts and/or trends in the data. Pareto charts were also used to identify opportunities for improvement with indwelling urinary catheter maintenance and care.
Analysis: Central line device utilization was calculated by the number of central line days divided by the number of patient days multiplied by 1,000. Catheter associated urinary tract infection rates were calculated by the number of CAUTI divided by the number of urinary catheter days multiplied by 1,000.
Implementation: The project included bi-monthly foley catheter audits and routine review of reports to identify patients that may qualify for removal of unnecessary urinary catheters or high-risk central lines. Obstacles included pushback from providers when questioned about need for or removal of indwelling devices. Physician Champions helped support the project.
Results/Discussion: Decrease in central line device utilization and catheter associated urinary tract infections in the hospital and Critical Care Unit. The hospital median CAUTI rate was reset from 0.78 to 0.00, with 1 CAUTI identified in 2023. The hospital median central line device utilization rate was reset from 143.82 to 130.53.
