UK Healthcare Systematic Approach to Decrease Hospital Acquired Urinary Tract Infections

Purpose:

Hospital acquired infection (HAI) is a critical patient safety concern. These infections are a reflection of hospital care provided to patients. The prevalence of HAI is widespread with catheter acquired urinary tract infections (CAUTIs) accounting for approximately 40% of HAIs with the highest rates in intensive care units. At the University of Kentucky we identified that our rates were higher than expected. We recognized that decreasing the number of infections was essential for patient safety. It was determined that a standard systematic approach was needed to identify gaps in care and determine appropriate interventions to lower our rates. The purpose of the performance improvement project was to create a standardized workflow that would provide a vehicle to identify and implement interventions that would lower our CAUTI rates.

 

Methods:

A CAUTI Steering and workgroup was established to develop a quality improvement plan to decrease the CAUTI rates.  Five spheres were identified to examine the possible causes for the high rates. The sphere included process, products, research, education-dissemination and evaluation.   In each sphere, gaps were identified by comparing evidence based practice and our current practice.   Once the gaps were identified the workgroup followed a systematic process of developing nursing guidelines, interventions, implementation plans and follow up.  Multiple items have been identified as gaps and successful interventions have occurred. This systematic process has proved to be the pivotal crux to begin decreasing the CAUTI rate. 

 

Results:

Developing the five spheres and creating a standardized workflow, our enterprise wide monthly ICU CAUTI rates have had significant decline. In the first quarter of FY 2014 our rates ranged from 5.9 to 9.0.  In October 2014 our rate decreased to 2.4.

                     

Conclusion:

Identifying specific areas of focus through our five spheres and having a standardized workflow proved to be instrumental in impacting patient safety. This process provided a vehicle to change nursing practice and a reduction in our CAUTI rates.