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Learning Objective 1: The learner will be able to discuss the importance of reducing Catheter Acquired Urinary Tract Infections (CAUTI) in a long term acute care facility.
Learning Objective 2: The learner will be able to identify the four recommended evidence base practice guidelines to help prevent Catheter Acquired Urinary Tract Infections (CAUTI).
The overuse of the indwelling urinary catheter is a significant problem in all healthcare settings. Up to five million urinary catheters are placed annually in the United States. The use of indwelling urethral catheters, while important and useful in certain clinical situations, can lead to patient discomfort, morbidity, and even mortality.
Purpose
The purpose of this quality improvement project was to determine the effectiveness of implementing a catheter associated urinary tract infection (CAUTI) prevention program guided by best practice recommendations. The four best practice guidelines were recommended by the Center for Disease Control and Prevention and the Society of Healthcare Epidemiology Association. The quality improvement project was implemented to decrease the CAUTI rates and decrease length of catheter days.
Method
In a quality improvement plan, 84 patients from a long term acute care hospital participated in best practice guidelines to prevent CAUTIs. The four best practice guidelines included: avoid unnecessary urinary catheters, insert urinary catheters using aseptic technique, maintain urinary catheters based on recommended guidelines and review urinary catheter necessity daily and remove promptly. CAUTI rates and length of indwelling urinary catheter days were evaluated before and after implementation.
Results
After implementing the recommended guidelines, CAUTI rates declined significantly from a mean rate of 13.25/1000 patient days to a mean rate of 3.66/1000 and catheter days decreased from a mean of 285 days/month to a mean of 283 days/month.
Conclusion
The positive outcomes supported implementing the four recommended evidence-based practices to reduce the CAUTI rates in a long term acute care hospital. The evidence-based practices guided the plan to reduce indwelling catheter usage, which reduced CAUTI rates.
Key Words: urinary tract infection, indwelling urinary catheters, catheter associated urinary tract infections, long term acute care.
See more of: Oral Paper & Poster: Evidence-Based Practice Contest