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Learning Objective 1: The learner will be able to discuss the reasons for the development of quality standards for implementaion of best practices.
Learning Objective 2: The learner will be able to describe the major factors influencing evidence-based quality & patient safety.
Abstract
The Centers for Disease Control and Prevention (CDC) (2008) and the National Healthcare Safety Network (NHSN) (2008) identified catheter associated urinary tract infections (CAUTIs) as one of the most common hospital-acquired infections in the United States affecting one million patients each year and significantly raising the cost of healthcare. On October 1, 2008, The Centers for Medicare and Medicaid Services (CMS) stopped reimbursing healthcare facilities for added cost of preventable hospital-acquired conditions known as “never events.” There are numerous studies in the literature that show that a nurse-generated reminder system can significantly decrease the duration of urinary catheterization, a primary risk for CAUTI. In concert with the hospital performance improvement initiative for reducing CAUTI, this evidence-based practice project was implemented in a 42 bed orthopedic unit in a Northern, New Jersey Hospital to determine whether a nurse-generated reminder system along with best practices related to indwelling catheter management would further decrease CAUTIs by 1-2% among adult post operative hip and knee replacement patients. A nurse-generated reminder system was implemented to prompt the physicians on a regular basis to consider whether a patient still needs a urinary catheter. A prospective and retrospective chart review was conducted using the surveillance protocols by the CDC/NHSN. The intervention resulted in a reduction of CAUTIs and catheter days. Infection rate was 0% (n=40) a decrease from 3% and the number of catheter days was 162 days (n=40), a decrease from 235 days. It is recommended that this pilot project be replicated using a larger sample size and for a longer period of time. Additionally, it is recommended that automatic prompts using computer technology be implemented to remind healthcare providers about discontinuing the urinary catheters, thereby reducing CAUTI risk and preventing harm to patients.
See more of: Oral Paper & Poster: Evidence-Based Practice Contest