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15-25% of people receive urinary catheters during their stay in the hospital.
UTI is most common healthcare associated infection (HAI).
-About 30% of HAI are CAUTI & estimated > 560,000 nosocomial UTI annually
75% of UTI acquired in hospitals are from urinary catheters.
Most important risk factor of CAUTI is prolonged use of urinary catheters.
Continued
STUDY: Complete analysis of data: How did or didnt the results of this
cycle agree with the predictions that we made earlier? Summarize the
new knowledge we gained by this cycle: Nurse and physician did concur
on whether catheters in these patients should be continued. More
testing with other nurses and physicians is necessary to ensure criteria
are clear and understood.
ACT: List actions we will take as a result of this cycle: Train other nurses
in use of the criteria and test further, monitoring concurrence between
nurses recommendations and physicians orders. Plan for the next
cycle (adapt change, another test, implementation cycle?): Test the
criteria with all day shift nurses on 3 South for three days. Stan will train
nurses on using criteria. Margaret will be liaison to other physicians and
communicate that this is still a test.
Continued
-23% of ER admits have a foley placed and is often unnecessary.
-21-63% of those patients did not have an appropriate clinical indication
So what are some appropriate clinical indication?
According to AORN
1. Acute urinary retention
2. Measurement of UOP for critically ill patient.
3. Periop surgery
4. Open sacral or perineal wound in incontinent patients
Conclusion:
Ways to Improve CAUTI Statistics for QI
-Follow Evidence-Based Guidelines for preventing CAUTI in the healthcare setting.
-Compliance monitoring of urinary catheter use (AUDITS)
-Provide continuing education for new and long-term clinical staff on indications for
urinary catheters, proper insertion, maintenance, and timely removals.
References
Centers for Disease Control and Prevention. 2014 National and State Healthcare-Associated Infections Progress Report. Published March, 2016.
Available at
www.cdc.gov/hai/progress-report/index.htm
Centers for Disease Control and Prevention. (2015, October 16). Catheter-associated Urinary Tract Infections (CAUTI). Retrieved March 3, 2016, from
http://www.cdc.gov/HAI/ca_uti/uti.html
Clarke, K. (2012, December 6). Reduction in catheter-associated urinary tract infections by bundling interventions. Retrieved March 21, 2016, from
http://intqhc.oxfordjournals.org/content/25/1/43
Hawaii State Department of Health. (2014, July 9). Healthcare-Associated Infections in Hawaii. Retrieved March 3, 2016, from
http://health.hawaii.gov/docd/files/2014/07/Hawaii-2013-HAI-Report-Final2.pdf
Knudson, L. (2014, May). CAUTI prevention requires improved practices and policies. Retrieved March 27, 2016, from http://www.aornjournal.org/article/S00012092(14)00377-9/pdf
Giles, Michelle (2015). Does our bundle stack up. Innovative nurse-led changes for preventing catheter-associated tract infections. Retrieved March 30, 2016 from
http://www.publish.csiro.au/?act=view_file&file_id=HI14035.pdf
Gould,
C.
(n.d.).
Catheter-associated
Urinary
http://www.cdc.gov/HAI/pdfs/toolkits/CAUTItoolkit_3_10.pdf
Tract
Infection
(CAUTI)
Toolkit.
Retrieved
Srejic, Elizabeth (2016, February). Biolfims and catheters: the mechanisms of infection.
http://www.infectioncontroltoday.com/articles/2016/02/biofilms--catheters-the-mechanisms-of-infection.aspx
March
Retrieved
How-to Guide: Prevent Catheter-Associated Urinary Tract Infections. (2011, December). Retrieved March 31, 2016, from
http://www.mnreducinghais.org/documents/CAUTI_How_to_Guide.pdf
March
30,
30,
2016,
from
2015
from: