573 A Novel Nursing Approach in Reducing Catheter-Associated Urinary Tract Infections in a Regional Burn Center

Abstract

Abstract Introduction Catheter-associated urinary tract infections (CAUTI) adversely affect more than 30% of patients in critical care hospital settings. Considered one of the most prevalent of nosocomial infections, CAUTI are linked to extended hospital stays, rising health care costs, and increased morbidity and mortality. CAUTI are attributed to prolonged catheter use, contaminated catheter insertion, and improper care and maintenance. Adhering to infection control guidelines is essential in preventing CAUTI in healthcare institutions. To illustrate, nearly 380,000 CAUTIs could be prevented and 9,000 lives saved, annually, with the prevention of CAUTI (Centers for Disease Control and Prevention, 2019). Methods Over the last nine months, our burn team has been working to reduce the CAUTI Standardized Infection Ratio (SIR) and Standardized Utilization Ratio (SUR) in the Burn Center. Efforts to facilitate this reduction include the education of nurses and providers on the indications for placement, replacement, and removal of indwelling urinary catheters. We also developed and assigned a PowerPoint presentation and post-assessment to staff members to educate and measure their understanding of the proper care for patients with urinary catheters in place. The hospital facility’s protocol was revised to reflect the specific needs and alternatives for urinary catheters in our burn patient population. The new burn specific protocol now serves as a guideline for the multidisciplinary team during daily rounds to reduce the risk of CAUTI in the Burn Center. Charge Nurses continue regular audits. Results The SIR benchmark for 2019 was 0.774. The SIR for the Burn Center in the third quarter of 2019 was incalculable because the predicted number was less than one. The SIR for the fourth quarter of 2019 was 0.913. The SUR benchmark for 2019 was 1. The SUR for the Burn Center in the third and fourth quarters of 2019 were 1.035 and 1.150, respectively. This data indicated the need for a comprehensive plan for improvement. Following the implementation of our team’s comprehensive improvement plan, the SIR and number of infections for the first quarter of 2020 was zero, which is below the SIR benchmark 0.727 for 2020. The improvement plan we instituted also reduced the SUR to 0.897 for the first quarter of 2020, compared to the benchmark of one for 2020. The SUR rate for the second quarter was 1.118. Conclusions Instituting this simple nurse-driven protocol has resulted in a noteworthy improvement in patient outcomes. Achieving benchmark goals remains a significant priority to our burn center team as we continue to see the progress and health benefits of fostering the safest care environment for our patients, while remaining financially responsible to our institution.