The IMC at Ascension Seton Medical Center Austin (SMCA) was experiencing a high rate of preventable Catheter Associated Urinary Tract Infections (CAUTI). For example, from July 1, 2013 through July 1, 2014, the IMC had 19 CAUTI events.
The traditional method of reviewing CAUTI events at the IMC included individual follow-up with the nurses directly involved with the patient, sometimes months after the infection occurred.
- To reduce the number of CAUTI events on the IMC unit to zero.
- To respond to infections in a timely manner and use a CAUTI event as a teachable moment for the entire unit.
Mallory Davis, RN, IV and Jeffery Bothof, RN, BSN, nurse educator on the IMC unit, initiated a new CAUTI review process, as part of a clinical ladder project, that was designed to promote a culture of safety and transparency on the unit. The CAUTI review identifies the team members who provided direct patient care during the seven-day period leading up to the date the infection was noted.
During the review, special attention is given to factors that can dramatically increase or decrease the chances of contracting a CAUTI (e.g., daily CHG wipe, peri-care, catheter exchange and necessity). Information gathered during chart reviews for all CAUTI’s and Central Line-Associated Bloodstream Infections (CLABSI) is now shared with the entire nursing team, not just supervisors or clinical managers. Reoccurring CAUTI prevention auditing was reinstituted at a unit level weekly to increase compliance and knowledge base.