Do no harm: Make an oath to eliminate catheter-associated urinary tract infections

<p>Shelleon Alford and Elizabeth Kitching</p>

Do no harm: Make an oath to eliminate catheter-associated urinary tract infections

Shelleon Alford and Elizabeth Kitching

Christiana Care, USA

: J Nurs Patient Care

Abstract

In 2014, the Transitional Medical Unit (TMU) at Christiana Care had 8 CAUTI (catheter-associated urinary tract infections). A team was assembled to create a plan of action to prevent future CAUTIs. In 2015, the TMU had only 1 CAUTI. The team developed an evidence-based monitoring tool and the TMU has been CAUTI free since September 2016. In summer 2017, the team adopted an electronic data collection system and the team leaders consistently monitor data collection and rounding compliance. The team utilizes participant observation and qualitative data collection with a goal of 100% daily monitoring compliance. The CAUTI prevention team also meets regularly to review best practices, reevaluate opportunities to decrease foley utilization and team members are expected to disseminate new education to their peers. Foleys were overutilized on the TMU. Foleys that were deemed necessary were not being cared for properly, increasing our CAUTI rates. The CAUTI prevention team identified staff educational needs and barriers to appropriate foley utilization. The surveillance tool was created to standardize foley catheter utilization and care, and the staff is educated and trained on an ongoing basis. Inconsistencies in foley catheter utilization and care led to high CAUTI rates on the TMU. A daily surveillance tool and ongoing staff education led to a reduction in CAUTIs by 100% and maintenance of 0% infection for 27 months and counting. Recommendations for future CAUTI prevention include sharing this surveillance model and daily rounding tool, and staff education and training program with other progressive care units.