Enhancing Infection Prevention's Role during Construction in a University Medical Center

Education continued with new nursing staff and reminders to existing staff of the importance of removing catheters. The Physician Epidemiologist responsible for the hospital's overall infection prevention program assured that physicians understood the hospital's quality initiative and reviewed data weekly in IC team meetings. The hospital's senior team reviewed CAUTI data by unit each month. The hospital also entered into a collaborative program with the state Quality Improvement Organization (QIO) to report CAUTI's and the AHRQ's 2009 Comprehensive Unit Based Safety Program (CUSP) to end healthcare associated infections HAI's. Results: Data collected prior to the nurse driven protocol demonstrated physicians ordered Foley catheters for inappropriate reasons (Graph 1). Physicians misunderstood criteria for catheter use for patients requiring comfort care at the end of life. Nurse educators and the Infection Control (IC) team provided educational sessions to staff about appropriate urinary catheter uses. The IC team rounded reinforcing proper catheter use. After implementation of the protocol, the facility found a decrease in catheter utilization in the intensive care units (ICUs) and the medical/surgical units (Graphs 2 and 3). Catheter utilization rates and number of CAUTIs show a significant decrease from 2010 to 2011 (Tables 1 and 2). Lesson Learned: Medical providers now look at catheter use seriously. Many alternatives to a catheter exist such as a bedpan, bedside commode, in and out catheterization of the patient, and adult diapers. Nurses' exhibit empowerment to remove the catheter when no longer needed.