Surgical teams at Northwestern Memorial Hospital in Chicago decreased the rate of catheter-associated urinary tract infections in their institution by focusing on the use of catheters before and immediately after operations, according to a recent study.
Findings from the study were presented at the 2015 American College of Surgeons National Surgical Quality Improvement Program Conference.
According to NSQIP outcomes comparison data, Northwestern Memorial Hospital had significantly higher CAUTI rates than at other similar hospitals, consistently ranking in the bottom 20 percent of NSQIP hospitals for CAUTIs.
In response, Northwestern Memorial implemented a process improvement program to reduce CAUTIs in the operating room.
"Our thought was to look at what happens in the OR and how we can get surgeons as well as surgical residents and nurses to think critically about using catheters," according to study author Anthony D. Yang, MD, an assistant professor of surgical oncology in the Surgical Outcomes and Quality Improvement Center at Northwestern University Feinberg School of Medicine.
Dr. Yang explains the surgical process improvement team developed consensus criteria for the placement of catheters depending on the expected length of each procedure. After implementing the program, researchers analyzed its impact.
Highlighted below are three findings from the study.
1. The rate of CAUTIs decreased from two per month on average in the months preceding the process improvement program to a rate of 0.4 per month over a period of five months after the program. In three of the five months after the process improvement program was implemented, there were zero CAUTIs.
2. Prior to the program, 67 percent of all catheters in patients who underwent surgical procedures were utilized in patients who may not have needed them. In the five months following the program implementation, unnecessary catheter use decreased 12 percent.
3. Only 22 percent of the catheters placed for surgery were removed immediately after the procedure, an issue considering prolonged use of catheters is considered to be the most common cause of hospital-acquired UTIs. The number of catheters that were removed within minutes of the completion of surgical procedures increased by 6 percent following the implementation of the program.
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