Abstract
Poster presentation
Session B presented Monday, September 30,11:30 am-12:30 pm
Purpose: Background: In quarter four of 2017, 40% of Catheter Associated Urinary Tract Infections (CAUTI) were attributed to the insertion of the indwelling urinary catheter in the Emergency Department (ED). The common practice of urgent insertion of indwelling catheters led to poor technique and increased CAUTI. Sterile procedures should be done in a sterile environment and not rushed. The creation of institutional guidelines for indwelling urinary catheter insertion coupled with physician and nurse champions led to a reduction in unnecessary utilization. Changes in practice, improved technique and reducing use of indwelling catheters in the ED lowered the incidence of CAUTI in our hospital by 70%.
Design: This was a quality improvment project.
Setting: 911 receiving ED at Providence Saint Joseph Medical Center with specialty center capabilities for STEMI and Stroke.
Participants/Subjects: Participants included all admitted patients from the ED who did not have a diagnosis of obstruction and/or therapeutic hypothermia.
Methods: A Plan Do Study Act (PDSA) process was used for this quality improvement project. The infection prevention team met with ED leaders and discussed the necessity of “Foley Free ED." Baseline data over two quarters was tracked. Data points established, the total number of foleys inserted, appropriateness of indication and presence of orders were analyzed. It was observed that indwelling urinary catheters were often inserted without orders or appropriate indications. The action plan included ED specific indwelling urinary catheter insertion guidelines and implementation of alternative external devices. An interprofessional staff education plan was implemented with weekly chart reviews to evaluate adherence of new guidelines.
Results/Outcomes: A two Tailed t-Test for the pre and post implementation period resulted with a p-value of 0.04. This indicates that the difference between the insertion rates are statistically significant. As a result of the “Foley Free ED†project, insertion rates have been reduced by 66%. CAUTI rates, per the National Healthcare Safety Network definition, declined from 3.17 in June 2018, to 0.96 in November 2018, which is a 70% reduction.
Implications: Implementation of “Foley Free ED†is associated with reduction of CAUTI cases attributed to indwelling urinary catheters inserted in the ED. Based on project findings, the authors suggest implementing practice guidelines that restrict indwelling urinary catheter insertion in the ED only to those undergoing therapeutic hypothermia or with urinary obstruction/retention.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Emergency Department, CAUTI, Foley Catheter
Recommended Citation
Buffham, Debra L.; Nocon, Rodan; Ohanian, Silva; Hernandez, Michael S.; Honore, Yolanda A.; and Garcia, Luzcorazon, "Reduction of catheter associated urinary tract infection (CAUTI) rates organization-wide begins in the ED" (2020). General Submissions: Presenations (Oral and Poster). 122.
https://www.sigmarepository.org/gen_sub_presentations/2019/posters/122
Conference Name
Emergency Nursing 2019
Conference Host
Emergency Nurses Association
Conference Location
Austin, Texas, USA
Conference Year
2019
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Reduction of catheter associated urinary tract infection (CAUTI) rates organization-wide begins in the ED
Austin, Texas, USA
Poster presentation
Session B presented Monday, September 30,11:30 am-12:30 pm
Purpose: Background: In quarter four of 2017, 40% of Catheter Associated Urinary Tract Infections (CAUTI) were attributed to the insertion of the indwelling urinary catheter in the Emergency Department (ED). The common practice of urgent insertion of indwelling catheters led to poor technique and increased CAUTI. Sterile procedures should be done in a sterile environment and not rushed. The creation of institutional guidelines for indwelling urinary catheter insertion coupled with physician and nurse champions led to a reduction in unnecessary utilization. Changes in practice, improved technique and reducing use of indwelling catheters in the ED lowered the incidence of CAUTI in our hospital by 70%.
Design: This was a quality improvment project.
Setting: 911 receiving ED at Providence Saint Joseph Medical Center with specialty center capabilities for STEMI and Stroke.
Participants/Subjects: Participants included all admitted patients from the ED who did not have a diagnosis of obstruction and/or therapeutic hypothermia.
Methods: A Plan Do Study Act (PDSA) process was used for this quality improvement project. The infection prevention team met with ED leaders and discussed the necessity of “Foley Free ED." Baseline data over two quarters was tracked. Data points established, the total number of foleys inserted, appropriateness of indication and presence of orders were analyzed. It was observed that indwelling urinary catheters were often inserted without orders or appropriate indications. The action plan included ED specific indwelling urinary catheter insertion guidelines and implementation of alternative external devices. An interprofessional staff education plan was implemented with weekly chart reviews to evaluate adherence of new guidelines.
Results/Outcomes: A two Tailed t-Test for the pre and post implementation period resulted with a p-value of 0.04. This indicates that the difference between the insertion rates are statistically significant. As a result of the “Foley Free ED†project, insertion rates have been reduced by 66%. CAUTI rates, per the National Healthcare Safety Network definition, declined from 3.17 in June 2018, to 0.96 in November 2018, which is a 70% reduction.
Implications: Implementation of “Foley Free ED†is associated with reduction of CAUTI cases attributed to indwelling urinary catheters inserted in the ED. Based on project findings, the authors suggest implementing practice guidelines that restrict indwelling urinary catheter insertion in the ED only to those undergoing therapeutic hypothermia or with urinary obstruction/retention.