Reducing Catheter Associated Urinary Tract Infection (CAUTI) in SICU CUSP Project 2022

From the 2023 HVPA National Conference

Muna Shehadeh BSN (JHAH), Margie Rose BSN, Rabie Kilan BSN

Introduction:
Healthcare-associated infection (HAI) leads to significant patient morbidity and mortality and is associated with an estimated 100,000 deaths per year.

A urinary tract infection (UTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney.

CAUTI is defined as a UTI in a patient who had an indwelling urinary catheter in place at the time or within 48 hours prior to infection.

According to National Healthcare Safety Network (NHSN) Urinary tract infections (UTIs) are the fifth most common type of healthcare-associated infection, with an estimated 62,700 UTIs in acute care hospitals in 2015.

In JHAH 2 CAUTI Incidents was reported in SICU –2021. UTI rate 2.2 UTI Utilization ratio 0.78

Research suggests CAUTIs are highly preventable and that perhaps as many as 50 to 70 percent of these episodes can be prevented.

Preventing health care associated infections is a high priority for our hospital by implementing evidence-based infection –prevention practice.

Aim:
To reduce the overall incidence of CAUTIs in SICU by 50% from our 2021 baseline of 2, continue to reduce CAUTIs by 50% each subsequent year.

Methodology:
Methodology used was prospective surveillance study of monthly CAUTI rates per 1000 device days during 2021/2022 in the surgical units. During the study period the data was extracted from the electronic medical record and reported monthly by the infection control team following the National Healthcare Safety Network Guideline. The team performed RCA root-cause analyses to identify contributing factors and gaps in the process and developed action plan.

Root Causes:
Prolong use of the urinary catheterPatient medical condition, incontinence patient
Out Of stock items for catheter insertion

Actions:
Prompting Catheter Removal by reviewing daily catheter necessity Preventing Unnecessary Placement of urinary cathetersEncourage use of alternative to urinary catheter Standardized urinary catheter Kit for insertion and enhanced practices. Emphasizing and monitoring the compliance with CUTI prevention bundle Validating the compliance with CAUTI prevention bundle by the infection control team.Emphasizing the importance of hand hygiene and monitoring compliance with the 5 moments of hand hygiene.

Result:
The result is promising and according to the infection control report as of September 2022 CAUTI rate in 3C is 0.8 with only one incident. The team will continue the journey until achieving the ultimate goal of zero.

Conclusion:
CAUTI reduction is possible in the ICU through a combination of interventions which include reduced catheter usage, improved catheter care (Aseptic insertion, use of closed drainage systems, proper maintenance and timely removal of indwelling urinary catheters), as well as the use of established practices such as hand hygiene and review CAUTIs incidents.

Bibliography:
National Safety and Quality Health Service (NSQHS) Standards National Healthcare Safety Network (NHSN) Healthcare Infection Control Practice Advisory Committee (HICPAC) Guidelines for Prevention of Catheter-Associated Urinary Tract Infections 2009 CAUTI Guidelines | Guidelines Library | Infection Control | CDCCatheter-associated Urinary Tract Infections (CAUTI) | HAI | CDC

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