Download UMC Yazdi.Hernandez CAUTI.032515

The CAUTI Crusher UTI Action Plan
and its Effects on CAUTI Reduction in
the Intensive Care Unit
CINDY HERNANDEZ
MARIAM YAZDI
Abstract
In order to address rates of Catheter Associated Urinary Tract
Infections (CAUTIs) in the ICU, a UTI Action Plan was crafted based
on researched techniques. ICU team members were educated on the
components of the Action Plan and the success of implementation was
tracked and analyzed after four months of implementation.
Trends
CAUTIs For Combined SICU and MICU 2010 - 2013
60
54
50
40
30
37
29
27
20
10
0
2010
2011
2012
2013
Project Goals
• The UTI Action Plan was instituted August 18th, 2014.
• To reduce infections by 15% for the remainder of 2014 (no more than
23 infections)
• To reduce infections by 30% by the end of 2015.
UTI Action Plan
Cultivating
Enthusiasm
Interprofessional
Collaboration
Ongoing
Education
UTI
Action
Plan
Performance
Improvement
Increasing
Awareness
Early Removal
and Catheter
Maintenance
Cultivating Enthusiasm
Ongoing Education
• CNAs and Nurse Technicians*
• RN Staff
• Critical Care Physicians
Increasing Awareness
• Bag Labeling
• Foley Day #
• Rounds
Early Removal and Catheter Maintenance
Remove catheter
within two hours
of MD order for
discontinuation.
Perform catheter
care with soap
and water every
twelve hours and
as needed.
Label collection
bag with date of
insertion.
Place alcoholbased cap on
collection port..
Ensure
securement
device is in place
to prevent microfriction within
urethra.
Prevent
obstruction of
urine within
drainage system
such as kinks in
tubing.
Maintain
collection bag less
than two-thirds
full to prevent
excess harboring
of bacteria.
Keep collection
back bellow level
of bladder to
prevent backflow of urine.
Prevent entire
collection unit
from coming into
contact with the
floor.
Performance Improvement
Interprofessional Collaboration
List of Identified Pathogens Related to Catheter-Associated Urinary
Tract Infections (CAUTIs)
E. coli
Pseudomonas aeruginosa
Enterococcus faecalis
E. coli ESBL
Klebsiella oxytoca
Acinetobacter baumannii
Enterobacter cloacae
Proteus mirabilis
Serratia arcescens
Staphylococcus epi
60
CAUTIs for Combined SICU and MICU
2010 - 2014
54
50
40
30
37
27
29
30
20
10
0
Total CAUTIs
2010
2011
2012
2013
2014
27
54
37
29
30
CAUTIs for Combined SICU and MICU
2014 – 2015
7
6
6
5
Action
Plan
5
4
3
3
2
3
3
2
3
2
1
2
1
0
Jan
Feb
0
March
1
0
April
May
June
July
Aug
Sep
Oct
Nov
Dec
Jan
Catheter Maintenance Performance Rates in
Combined ICUs
0.0%
100.0%
90.0%
0.0%
11.7%
16.0%
0.0%
3.3%
8.0%
10.0%
80.0%
70.0%
60.0%
100.0%
50.0%
40.0%
100.0%
81.7%
83.3%
79.0%
80.0%
30.0%
20.0%
10.0%
8.3%
0.0%
Proficient
Improvement Potential
91.7%
100.0%
81.7%
Future Objectives
• Nurse Driven Protocol for Catheter Removal
• Prevention Team
References
Eliminating Catheter-Associated Urinary Tract Infections. Health Research & Educational Trust, Chicago: July
2013. Accessed at www.hpoe.org.
Health and Research Educational Trust; CUSP, Eliminating CAUTI: A National Patient Safety Imperative.
(2013). Interim Data Report on the National On the CUSP: Stop CAUTI Project. Retrieved from
http://www.ahrq.gov/professionals/quality-patient-safety/cusp/using-cusp-prevention/cautiinterim/cauti-interim.pdf
Martinez-Resendez, MD, M., et al. (2014). Impact of daily chlorhexidine baths and hand hygiene compliance on
nosocomial infection rates in critically ill patients. American Journal of Infection Control, 42, 713-717.
Rebmann, T., & Greene, L. (2014). Preventing Catheter-associated Urinary Tract Infections: An Executive
Summary Of The Association For Professionals In Infection Control And Epidemiology, Inc, Elimination
Guide. American Journal of Infection Control, 644-646.
Strategies to Prevent Catheter‐Associated Urinary Tract Infections in Acute Care Hospitals. (2008). Infection
Control and Hospital Epidemiology, Vol. 29(S1). Retrieved August 1, 2014, from
http://www.jstor.org/stable/10.1086/591066
.