A multifactorial project focused on reducing Catheter-Associated Urinary Tract Infections (CAUTIs). This comprehensive approach included daily audits by the nursing department to prompt early removal recommendations, enhanced electronic health record (EHR) processes for specimen collection and Best Practice Alerts, staff education, and an improved method for analyzing any CAUTI event that occurred. This was a multidisciplinary approach involving Infection Prevention teams, Nursing Informatics, Nursing quality, Antimicrobial Stewardship and the Clinical staff education teams. These combined efforts reduced frequency of CAUTIs and allowed the organization to improve patient care.
Problem: Our CAUTI rates surpassed national benchmarks, more than doubling and continuing to trend upward (Centers for Disease Control and Prevention, 2023). This trend led to a decrease in patient outcomes, an increase in financial costs, and a decline in the quality of patient care being provided (Shuman & Chenoweth, 2018).
Measurement: The organizations CAUTI rates were reviewed and monitored on a week-to-week basis. Lastly, when CAUTI events did occur, a robust process for real time analysis of events was implemented to identify gaps in care and prevent future occurrences.
Analysis: Multiple barriers were suggested as the cause of our high rates including improper insertion, contamination during specimen collection, Urinalysis ordered without cause, and catheters in place without appropriate indications. Recognizing the urgency of the situation, our teams identified interventions aimed at breaking down these barriers and improving our patient care.
Implementation: The literature showed a multifaceted approach was the best method for reduction. All staff were re-educated on catheter care competencies. Daily audits were completed on patients with a catheter in place for more than two days. Nurses were contacted for discrepancies. Multiple Best Practice Alerts were created to improve care.
Results/DiscussionOver 3500 staff members received hands-on competency training, and over 3000 patient charts were audited. During that time, a dramatic reduction in CAUTI rates was seen. There were zero CAUTIs for four weeks which was significantly lower than the one to two CAUTIs seen per week in the previous year.
