818 A Themed Approach to Decreasing CAUTI

Abstract

Abstract Introduction In 2017 a high incidence of Catheter Associated Urinary Tract Infection (CAUTI) was recognized in the burn unit. Initially, when there were 4 CAUTIs recognized, analysis of the factors that led to the CAUTIs was done by the practice council and leadership team. Methods Initially, education specific to burn catheter use and areas of improvement was disseminated and included the CDC’s research on biofilm formation, variables that cause CAUTI, and the key factors to prevent CAUTI. This was followed by a test to assess for knowledge retention. In addition, one on one education was provided to each Burn staff member to ensure appropriate performance and documentation of insertion, pericare, urinary catheter care, and the significance of discontinuation of urinary catheter utilization at the earliest possible time. This education was then disseminated in a hospital wide campaign called “CAUTI Task Force: May the “Force” be with us”. This was a Star Wars themed initiative that featured a video of Star Wars clad task force members battling the CAUTI. Emphasis was placed on pericare, documentation, and decreasing the urinary catheter standard utilization ration based on a hospital acceptable reasons to continue catheter use. Urinary catheter utilization was addressed by staff daily at morning multidisciplinary rounds. Self-audits and audits by nursing leadership were performed to evaluate for improvement of the main education points of pericare, documentation, and early urinary catheter removal/necessity of catheter use. Results Successes were noted by continuing to count how many weeks since the last CAUTI and were celebrated with “Pee Parties” that had yellow themed food and drinks. A total of 36.5 weeks (8.5 months) without a CAUTI was recognized at 12 weeks and at 6 months. Ultimately, here was a reduction in CAUTIs from 6 in 2017 to 1 in 2018. The standard utilization ratio for catheter use decreased from 1.66 in 2017 to 1.18 in 2018. Conclusions There was great momentum and staff interest in the Star Wars theme and the recognition with “Pee Parties”. Further work is ongoing to decrease the standard utilization ratio for catheter use to below 1. This initiative has continued into 2019 to add other methods to reduce utilization use of a hospital wide data tool to detect usage of catheters in place longer than 4 days. Applicability of Research to Practice The interventions chosen were all focused on increased awareness, focus, and placing importance on improving a problem that nurses knew was harmful to their patients. There were negligible costs other than staff time for implementation, audits, and education. The results achieved are statistically significant. The implementation had great benefit with little risk. Engagement and entertainment helped to increase nurse retention and focus on the actions that would achieve results.