A nurse taskforce at Roswell Park Cancer Institute in Buffalo, N.Y., found the catheter-associated urinary tract infections bundle they implemented has successfully reduced infection rates. The taskforce presented their results at the Oncology Nursing Society 41st Annual Congress.
According to the oral presentation, the CAUTI rate at Roswell Park Cancer Institute decreased from 3.8 CAUTIs per 1,000 catheter days in the fourth quarter of 2012 to 0.9 CAUTIs per 1,000 catheter days during the second quarter of 2015.
Ten elements of the bundle included:
- Limiting catheter insertion frequency for appropriate cases, such as when strict inputs and outputs are required or the patient is sedated, as well as length of insertion time
- Developing an electronic medical record prompt to evaluate daily medical necessity
- Updating EMR nursing flow sheets to capture accurate data
- Completely overhauling catheter inventory
- Standardizing catheter supplies and catheter maintenance practices
- Implementing a bladder scanner protocol algorithm
- Having nurse leaders, infection preventionists and supply vendors educate nurses on the entire CAUTI bundle for more than one month
- Building a website for CAUTI prevention with links to information and a checklist.
- Having staff create inexpensive instructional videos
- Recruiting nurse champions of the CAUTI bundle
While the bundle was successful, the hospital continues to add new elements to improve care.
"Our most recent innovation and modification is the implementation of CAUTI root cause analysis for each CAUTI developed by a nurse, including the urology physician champion, unit nurse administrator, nurse involved in the insertion, practitioners involved in documentation and the quality nurse," said Pamela McLaughlin, BSN, RN, assistant magnet coordinator at Roswell Park Cancer Institute.
More articles on CAUTIs:
10 takeaways from CMS' Quality Improvement Organization Program progress report
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UTI intervention remains successful for 8 years, study finds