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Virtual Learning Session 1: Pre-work Facilitator Notes Purpose The purpose of this pre-work is to prepare facility teams to actively participate in the two-hour virtual learning session that kicks off the start of the project. HRET created two resources to assist you in understanding and applying the main cultural and clinical interventions: C.A.U.T.I. for clinical interventions and T.E.A.M.S. for cultural interventions. You will watch two short videos that give you the opportunity to apply the clinical and cultural interventions using the C.A.U.T.I. and T.E.A.M.S. mnemonics. While we understand that the videos are filmed in a hospital setting, a majority of the situations and observations in the video relate to the interventions of this project. We do understand that the application of the interventions may vary in the long-term care (LTC) setting or in your facility. Instructions 1. Download, print and review the C.A.U.T.I. and T.E.A.M.S. infographics. We recommend that you print these infographics in color so that you can post them in your workspace. 2. Watch CaUTI Prevention 2015i and Reducing CAUTI Incidents at the Meijer Heart Centerii. 3. Referencing the infographics, think about how the C.A.U.T.I. and T.E.A.M.S. mnemonics are represented in the videos. Consider the following: a. Using the C.A.U.T.I. infographic: i. Identify which clinical interventions were highlighted in each of the videos. FACILITATOR NOTES: CaUTI Prevention 2015 Reducing CAUTI Incidents at the Meijer Heart Center Catheter removal Clinical indication for Focus of rapid performance catheter improvement was to Remove it when no longer remove catheters, improve indicated catheter care Aseptic insertion N/A N/A Use regular assessments Consider alternatives Daily risk assessment Communication about removing catheter Training for catheter care Train staff, resident and Catheter care: kept family drainage bag below the o Addressed by pointing bladder, disinfected out the lack of hand sampling port before hygiene, bag on the obtaining a urine culture floor and kinked tubing Incontinence care planning Alternatives to catheter were not considered i. N/A What challenges do you foresee in implementing these CAUTI prevention strategies in your facility? b. Using the T.E.A.M.S. infographic: i. Identify the interactions in CaUTI Prevention 2015 that do not support team formation and excellent communication. FACILITATOR NOTES: Team formation: Dr. Catheter was the team leader, but very hesitant to make a decision about the catheter. The nurses were also hesitant to remove the catheter, despite the protocol. Excellent communication: There was poor communication between the preceptor and the nurse. Assess what’s working: The nurses and doctors did a poor job assessing the true impact of the catheter. Meet monthly: There was no face-to-face communication between the physician and nursing staff. Sustain efforts: There was no sustained plan to promote optimal care. ii. Describe how Spectrum Health Butterworth Adult Critical Care applied these cultural interventions in Reducing CAUTI Incidents at Meijer Heart Center. FACILITATOR NOTES: Team formation: Administrator (VP) buy-in, charge nurses Excellent communication: Daily rounding and risk assessments Assess what’s working: Success led to visual management cues for catheter care, use of regular assessments Meet monthly: N/A Sustain efforts: Revised protocol so that nurses didn’t need to call physicians to get an order to remove catheter, daily rounding to assess medical necessity to remove catheters as soon as possible. iii. What challenges do you foresee in implementing the cultural interventions to improve safety culture in your facility? c. You may want to identify what aspects of the videos are specific to the hospital setting and do not necessarily apply in the LTC setting, particularly in the facility you work in. FACILITATOR NOTES: One example is that nurse-driven protocol is a facility-level policy decision. Key to Success: 1. Discuss how these clinical and cultural interventions are currently being applied (or not applied) in the LTC facility you work in with your team. i Richards, T., Burgess, A. (2015, Jan. 21). CaUTI Prevention 2015 [Video file]. Retrieved from: https://youtu.be/QTcNVUZQf0w. ii Spectrum Health. (2015, Mar. 13). Reducing CAUTI Incidents at the Meijer Heart Center [Video file]. Retrieved from: https://youtu.be/WPFSlGccmxE. 2