Reducing CAUTIs in a neuro-spine ICU: 5 steps

Researchers at the Northwestern Memorial Hospital in Chicago created a five-step approach to reducing catheter-associated urinary tract infections in the hospital's neuro-spine intensive care unit and published the results in the American Journal of Infection Control.

"Due to the complex nature of neuro-spine intensive care unit patients who often have urinary retention and limited mobility, preventing CAUTIs is challenging," wrote the study authors. "NSICUs traditionally have the highest CAUTI rates; thus, novel interventions are needed in this population."

The Northwestern Memorial NSICU was no exception; from July 2011 through July 2012, 48 CAUTIs occurred in five intensive care units at the institution, 22 (or roughly 46 percent) of which occurred in the NSICU.

To combat this problem, the researchers' creased a stepwise approach that included:

1. Reviewing retrospective data on culture information for surveillance using data mining

2. Having an infection prevention team conduct daily rounding with clinicians to gain an understanding of the challenges the NSICU population faces

3. Developing and implementing a NSICU CAUTI-reduction action plan that consisted of having nurse leaders perform daily assessments of every patients' need for indwelling urinary catheter and having either IP staff or nursing leadership do daily rounds

4. Conducting practice audits to measure compliance with rounding and catheter securement; and

5. Sharing real-time data outcomes and infection rates with the entire NSICU care team.

Ultimately, compliance with catheter securement rose to 100 percent toward the end of the study, the CAUTI rate decreased from 8.18 to 0.93 per 1,000 catheter-days and the standardized infection ratio decreased from 2.16 to 0.37 after implementing the five-step effort.

According to the study authors, the action plan was considered successful by the institution since the number of CAUTIs was largely reduced and the change was sustained.

"The culture of our NSICU now includes an increased mindfulness when evaluating catheter necessity, care, and removal," wrote the authors. "The success of this patient population-specific intervention serves as a model for future HAI interventions elsewhere in our institution."

 

 

More articles on CAUTIs:
13 stories this year on CAUTIs, CLABSIs
51 statistics on state CAUTI rates
Study evaluates Natural Language Processing and CAUTI surveillance: 3 findings

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