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Janelle Davidson

on 29 November 2012

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Transcript of CAUTI-COMPLEX

Catheter Associated Urinary
Tract Infections (CAUTIs) By: Janelle Davidson
& Liz Ellis Picot Question Thesis Preventing catheterization Nursing Initiatives Nursing Initiatives Continued Aseptic Technique Current Practice P: Any catheterized patient in the health
care setting.
I: Special initiative for prompt catheter
C: Versus routine procedure for catheter
O: Decrease catheter associated urinary
tract infections.
T: During the patient's length of hospital
stay. Preventing catheterization, aseptic
technique, nursing initiatives, and prompt
removal are all factors that contribute to the
decline of indwelling catheter infections. No clear protocol for catheter placement.

Criteria included in the research:
-Urinary retention (neurogenic bladder)
-Urine Tract Obstruction (blood clots, enlarged prostate, urethral problems)
-Close monitoring of urine output of critically ill and immobile patients.
-Urinary incontinence that poses a risk for a stage 3 pressure ulcers.
-Comfort care for terminally ill patients. Overall reduces the risk for infection
Competency Based Training
-Wash hands
-Don sterile gloves
-Maintain sterile technique while cleaning the meatus and upon insertion.

Important factors: Keep the tubing unclamped, disinfect the drainage spigot after emptying the bag, and place the bag below the bladder at all times. 1.Concept map for management of urinary retention
-Daily checklist was applied to see if the catheter was still needed.
Catheter days decreased from 402 to 390. Overall Cauti rate reduced from 2.88 per 1000
catheter days to 1.46
2. Nursing identifies patient's with catheter placement. Daily communication with the Dr. about continued placement and if it is still necessary after 5 days.
Indwelling catheter days from 311.7 to 238.6
CAUTIs from 4.7/100 catheter days to zero. Physicians are only aware of catheterization
30% of the time.
Face-to-face reminders. Dr. decision to maintain or discontinue after 48 hours.

Nurses allowed to discontinue catheters that
are no longer needed.
Additional education sessions on catheter use , alternatives, and bladder scanning
42% reduction of duration
one year follow up 79% reduction in duration Unspecified and lenient protocol

Focused more for nursing convenience
and patient request.

Additional studies to reduce CAUTIs and
ensure better patient outcomes.

Actively implement EBP interventions Patient Standard of Care -Assess all patients with catheters on a daily basis
-Recognize when they are unneeded
-Communicate effectively with Dr to initiate prompt removal.
-Maintain aseptic technique
All preventing thousands of infections and financial hardship for hospitals Question What have you seen in the clinical setting that could
A. Increase incidence of CAUTIs
B. Decrease incidence of CAUTIs References: Bernard, M. S., Hunter, K. F., & Moore, K. N. (2012). A Review of Strategies to Decrease the Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence of Catheter- Associated Urinary Tract Infections. Urologic Nursing, 32(1), 29-37.

Blodgett, T. (2009). Reminder systems to reduce the duration of indwelling urinary catheters: a narrative review. Urologic Nursing, 29(5), 369-379.

Elpern, E., Killeen, K., Ketchem, A., Wiley, A., Patel, G., & Lateef, O. (2009). Reducing use of indwelling urinary catheters and associated urinary tract infections. American Journal of Critical Care, 18(6), 535-542. doi:10.4037/ajcc2009938

Fuchs, M., Thornlow, D., & Chamagne, M. (2011). Evaluation of an evidence-based nurse driven checklist to prevent hospital-acquired catheter associated urinary tract infections in intensive care units. Journal of Nursing Care Quality, 26(2), 101-109.
Hart, S. (2008). Urinary catheterization. Nursing Standard, 22(27), 44-48.

Saint, S., Meddings, J., Calfee, D., Kowalski, C., & Krein, S. (2009). Catheter-associated urinary tract infection and the Medicare rule changes. Annals of Internal Medicine, 150(12), 877-884.
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