Description
Recognize effective interventions to reduce CAUTI rates in the MICU through unit-based protocol formulation, aggressive staff education and hands-on simulation.
Purpose
The purpose of this unit-based study is to provide answers to the best practice question: “What are the best practices for preventing catheter-associated urinary tract infections (CAUTIs) in critically-ill adult patients?”
Significance
Findings from the 2014 NDNQI Data led the Medical Intensive Care Unit (MICU) Council to establish unit-based initiatives including MICU CAUTI Bundles and aggressive staff education and hands-on simulation. A review of the current literature and guidelines (Flodgren et al., 2013, Wald et al., 2012) led to the formulation of the unit-based protocol during the fourth quarter of 2014, including indwelling catheter indication, early catheter removal, bladder scanner utilization, and good nursing practice. Commencement of staff education during the first quarter of 2015 in the form of annual skills fair, monthly Unit Council meetings, and daily charge nurse huddles ensured fast dissemination of information and skills. Laminated badge cards specifying elements of the CAUTI Bundles are also distributed to the staff during this timeframe. Additionally, designation of a CAUTI Unit Champion for both day and night shifts monitored staff compliance and performed inpatient rounding twice a week.
Evaluation
From the first quarter of 2014, the MICU had 12.16 cases of CAUTI per 1,000 catheter days. A drastic fall in CAUTI rates starting in the first quarter of 2015 (0 cases per 1,000 catheter days) proved that evidence-based changes in nursing interventions are indispensable in preventing CAUTIs. Based on 2015 NDNQI data, MICU’s CAUTI rate is well below the national benchmark. The utilization of the MICU CAUTI Bundles and aggressive staff education proved, and continue to be a success.
Implications for Practice
Nursing implications include assessment of catheter indication, early catheter removal, and continuing assessment of skills and knowledge of nursing staff to be successful indicators of decreased CAUTI rates (Wald et al., 2012).
See more of: Evidence-Based Practice Sessions: Oral Paper & Posters