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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