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Let’s Prevent CAUTI Together!

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Leticia Garcia, RN, BSN | Michelle Kim, RN, BSN | Kelsey Reyes, RN, BSN
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8 East / 8 West - General Surgical Unit | Ronald Reagan UCLA Medical Center

INTRODUCTION/PURPOSE
(click to add) CLINICAL (click toINTERVENTIONS
add) INTERVENTIONS (click to add)
RESULTS
RESULTS
(cont)
(continued)
ISSUE/CURRENT
Between May 2017-May 2018, PRACTICE
8E and 8W units at A pretest and posttest was given to the staff of 8E & 8W to gather baseline data of Post-implementation 89% of RN’s accurately stated
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Ronald Reagan UCLA Medical Center has showed a Enter your text herestaff knowledge on foley care management. Questions about foley catheter care, use that CHG wipes were the standard practice for
significant increase in catheter-associated urinary tract of the nurse driven protocol, and overall confidence in preventing CAUTI was given to performing foley.
Enter your text here
infections (CAUTI) cases, with a total of 22 cases in this evaluate the effectiveness of this project overtime.
timeframe. CAUTI prevention continues to be an area
of improvement on both units especially with a high- An educational powerpoint was created to educate staff on Foley Catheter Care and
risk population that includes urology, trauma, and the importance of preventing CAUTI. We worked closely with the unit Nurse Educator
head/neck patients. To address this issue, an evidence- to implement our project with annual CAUTI prevention competencies. This included
based practice project was implemented and results showing proficiency of catheter care by teach back and return demonstration. Our
evaluated post-project in both units. The objective was units also performed foley catheter audits which included reason for foley, position of
to test the effects of an implementation of foley foley bag, foley care, and patient education.
(urinary catheter) care management and educational
bundle compared to current practice to reduce CAUTI A patient education handout was created, distributed to patients, and RNs provided
rates. teaching about foley catheters, importance of catheter care, early removal, and
LITERATURE REVIEW/ prevention of CAUTI with teach back by patients. This was also supplemented with the
(click to add)
SYNTHESIS OF EVIDENCEAVAILABLE UCLA nurse driven protocol which facilitates working closely with RN’s and MD’s for
(click
early toofadd)
removal catheterOUTCOMES
to prevent CAUTIMEASURED
as well as working closely with the charge
EVIDENCE/LITERATURE
Catheter-associated REVIEW
urinary tract infections are one of nurse for checking daily need for foley catheters on the unit5.
CONCLUSION
the most
Enter common
your hospital infections that can lead to
text here Enter your text here Education and implementation of strategies to reduce
longer stays, greater costs, and increased morbidity OUTCOMES MEASURED/RESULTS CAUTI (aseptic technique, catheter care, early
and mortality3 . 75% of UTI’s in the hospital setting removal) showed promise in reducing rates although
occur from foley catheters, the risk for CAUTI increases limitations exist. A limitation of our project included
Both CAUTI and foley care needing a longer timeframe to implement research.
3 to 10% daily, while preventable measures may help
have been fluctuating each Reeducation every few months would also be
reduce 17 to 69% of CAUTI causes2. month. 80% of RN’s felt beneficial to keep consistency of staff education
strongly about performing morale on the unit. In addition, due to the fact that
Research has shown improvement in reducing CAUTI foley care, post- HCAHP scores are still being processed for this
rates through implementation of foley care implementation which is an (click to add) RESULTS quarter,(click toAugust
June and add)CAUTICONCLUSION
rates have not been
management. In such studies use of continuing increase from the 76%.
(click to add) EBP QUESTION
education on CAUTI and implementing strategies to 89% of your
RN’s were
gathered. As a result, we are unable to measure the
Enter text able
hereto Enter your text
effectiveness of ourhere
project in reducing CAUTI rates on
reduce CAUTI such as early foley catheter removal accurately demonstrate that our units.
Enter your text here
decreased CAUTI rates by 25-30%1. Another study foley care should be
achieved a 33-35% reduction in CAUTI through performed each shift and Although further research is needed by implementing
implementing multidisciplinary educational training after each bowel movement, quality improvement interventions and continuing
with staff and patients, utilizing posters in units, post-implementation. education, we can significantly sustain reduction in
reevaluating need of the catheter daily, and CAUTI rates on our Medical-Surgical Units. We will
continuously evaluating staff on foley competencies 4. continue to monitor HCAHPs scores on a quarterly
basis to evaluate if interventions are successful in
PICOT QUESTION reducing CAUTI rates.

In medical surgical patients from 8E and 8W, how does REFERENCES

the implementation of foley care management 1 Bell,
M. M., Alaestante, G., & Finch, C. (2016). A Multidisciplinary Intervention to Prevent Catheter-Associated Urinary Tract Infections Using Education,
Continuum of Care, and Systemwide Buy-In. The Ochsner Journal,16(1), 96-100.

compared to current practice impact the number of 2 Centersfor Disease Control and Prevention (CDC). (2016). Guideline for Prevention of Catheter-Associated Urinary Tract Infections.Retrieved from
https://www.cdc.gov/infectioncontrol/guidelines/cauti/background.html

foley catheter infections?

3Purvis,S., Gion, T., Kennedy, G., Rees, S., Safdar, N., Vandenbergh, S., & Weber, J. (2014). Catheter-Associated Urinary Tract Infection. Journal of Nursing Care
Quality,29(2), 141-148. doi:10.1097/ncq.0000000000000037

4Theobald, C. N., Resnick, M. J., Spain, T., Dittus, R. S., & Roumie, C. L. (2017). A multifaceted quality improvement strategy reduces the risk of catheter-
associated urinary tract infection. International Journal for Quality in Health Care,29(4), 564-570. doi:10.1093/intqhc/mzx073

5University
of California Los Angeles. (2017). Assessment and removal of unnecessary urinary catheters (UCLA Policy HS 175). Retrieved from https://ucla-
ronaldreagan.policystat.com/policy/4042412/latest/