Devoid of Catheters - Strategies to Reduce CAUTI's

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Primary Author:</td>
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Deborah Stabell Tran, MS, BSN, RN</td>
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Co-Principal Investigators/Collaborators:</td>
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Catherine Bailey, PhD, RN, CNE, Neil Fried, MSN, RN</td>
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Organization:</td>
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Texas Health Presbyterian Dallas</td>
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Abstract</h2>
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Purpose</h3>
<p>Due to the unnecessary nature of many catheters, healthcare providers need knowledge of evidenced based ways to reduce CAUTI's and prevent unnecessary insertions and methods to reduce duration of urinary catheter dwell time.</p>
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Background</h3>
<p>CAUTIs are the most prevalent nosocomial infection; they begin developing with 16 hours of catheter insertion and the triple the mortality of patients with other diseases. In addition to the human cost, there is a financial burden to the families, patients and healthcare settings that provide care for this “never event”. While the evidenced based reasons for using a catheter are few, healthcare providers continue to place unnecessary catheters, adding to the risk of harm for their patients</p>
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Materials & Methods</h3>
<p>Appraisal of six research studies dealing with different methods to reduce CAUTIs. Facets that were researched include: reminder methods that a catheter is indwelling, bladder bundles that assess appropriate use, and retraining of healthcare provider on evidenced based reasons for urinary catheters as well as acceptable care for the catheter.</p>
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Results</h3>
<p>All studies had a reduction in CAUTIs for their studied care area, both those that targeted keeping the catheter out of the patient and those that focused on dwell time for those that a urinary catheter was necessary.</p>
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Conclusion</h3>
<p>With competing priorities in the healthcare setting, reminder systems that allow for daily assessment of urinary catheter necessity, puts this important issue back on the forefront of the bedside clinician. Multi-faceted approach, including re-education of staff to evidenced based uses of urinary catheters, provided positive outcomes for facilities looking to reduce their catheter usage and CAUTI rates.</p>
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Bibliography</h3>
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Centers for Disease Control (2014a). Catheter-associated urinary tract infection (CAUTI) event. Device associated module: CAUTI. Retrieved from http://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf</li>
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Centers for Disease Control. (2014b). Catheter-associated urinary tract infection (CAUTI) event. Patient Safety Component Manual, 7-1. Retrieved from http://www.cdc.gov/HAI/pdfs/toolkits/CAUTItoolkit_3_10.pdf</li>
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Gould, C. V., Umscheid, C. A., Agarwal, R. A., Kuntz, G., Pegues, D. A., & Healthcare Infection Control Practices Advisory Committee. (2009). Guideline for prevention of catheter associated urinary tract infections 2009. Department of Health & Human Services – Centers for Disease Control. Retrieved from http://www.cdc.gov/hicpac/pdf/CAUTI/CAUTIguideline2009final.pdf</li>
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Grabe, M., Bjerklund-Johansen, T. E., Botto, H., Wullt, B., Cek, M, Naber, K., G., …Wagenlehner, F. (2011). Catheter-associated UTIs. In: Guidelines on urological infections. National Guideline Clearinghouse – Guideline Summary NGC-8621, Agency for Healthcare Research and Quality. Retrieved from http://www.guideline.gov/content.aspx?id=34100&search=catheter+uti</li>
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Joint Commission. (2011). Clinical Care Improvement Strategies: Preventing Catheter-Associated Urinary Tract Infections. Joint Commission Resources, Inc: Oakbrook Terrace, Illinois. Retrieved from http://www.jointcommission.org/topics/hai_cauti.aspx</li>
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Marigliano, A., Barbadoro, P., Pennacchietti, L., D’Errico, M., M., Prospero, E., & the CAUTI Working Collaborative Group (2012). Active training and surveillance: 2 good friends to reduce urinary catheterization rate. American Journal of Infection Control, (40), 692-695. doi:10.1016/j.ajic.2012.01.021</li>
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Meddings, J., Rogers, M. A. M., Krein, S. L., Fakih, M. G., Olmstead, R. N., & Saint, S. (2013, September). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Quality & Safety Online First. doi:10.1136/bmjqs-2012-001774</li>
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<p>© Improvement Science Research Network, 2012</p>
<p>The ISRN published this as received and with permission from the author(s).</p>