| Primary Author: | Katreena Collette Merrill, RN, PhD Candidate |
| Co-Principal Investigators/Collaborators: | Wendy Parmley, Mary Jo Ford, Abbie Kim, Karen Singson |
| Organization: | Brigham Young University College of Nursing |
Abstract
Background
Catheter associated urinary tract infections (CAUTI) are the most prevalent healthcare acquired infection. Inpatient rehabilitation patients are particularly vulnerable to CAUTI. The feasibility of implementing an evidence-based urinary catheter bundle to prevent CAUTI in rehabilitation patients has not been well studied.
Purpose
To decrease healthcare acquired CAUTI through the implementation of a standardized urinary catheter bundle in an inpatient rehabilitation unit and to determine the feasibility of implementing this improvement process.
Materials
Evidence based computer training for each RN, nursing assistant and therapist assigned patients with urinary catheters. Supplies for skills pass offs (urinary catheter manikin and catheter kits). Standardized prevalence audit forms completed by RN staff. Weekly staff reminders posted in the break room and e-mailed.
Methods
A prospective intervention study with a retrospective comparison group was used. During 4th quarter 2010, multifaceted evidence based nurse-led urinary catheter bundle including baseline computer based training, skills pass off and real-time feedback was implemented. The urinary catheter bundle included appropriate catheter indications, proper care and securement, documentation and patient teaching. CAUTI rates and urinary catheter days were collected for eight quarters prior to the intervention and will be compared to prospective quarterly data for the next eight quarters. A prevalence study was conducted at baseline and each week thereafter. The prevalence data was used as a real-time audit to provide feedback to the staff.
Results
In the 4th quarter of 2010, 100% of all RNs, nursing assistants and therapists received the intervention. Baseline data indicated the following: CAUTI rate 14% CAUTIs per Foley catheter days, appropriate urinary catheter indications 100%, proper care 38%, proper securement 50%, documentation 50%, and patient teaching 0%. The first quarter results will be available for analysis in April 2011. The target goal is to decrease CAUTI to 4% per Foley catheter days.
Conclusion
A nurse-led urinary catheter bundle may be effective in decreasing CAUTI. More data is needed to determine feasibility and sustainability of this evidence based improvement project.
© Improvement Science Research Network, 2011