964. Journey to Zero Harm: Eliminating Catheter-Associated Urinary Tract Infections (CAUTIs) for 12 Consecutive Months at Two Community Hospitals

Abstract

BackgroundMany US hospitals have implemented CAUTI prevention bundles (CPB) but few have achieved the goal of zero CAUTIs for 12 consecutive months. We report our journey to zero harm at two community hospitals that have each successfully eliminated CAUTIs from all their units, including the intensive care unit (ICU), for over 12 consecutive months.MethodsFrom April 2015 to March 17 (Period A), CPB was implemented at University of Maryland-Upper Chesapeake Medical Center (UM-UCMC) and University of Maryland-Harford Memorial Hospital (UM-HMH), each with 195 and 128 beds, respectively. UM-UCMC has a 15-bed ICU while UM-HMH has a 5-bed ICU. The CPB included placement of urinary catheters only for approved indications, use of two persons (buddy system) for catheter insertion, Nurse Driven Protocol for catheter removal, and silver-impregnated cloths for perineal care. A massive frontline engagement campaign “You can’t have a CAUTI if you don’t have a foley” was launched from April 2017 to March 2019 (Period B). The focus was intensified on reducing catheter utilization rates. Real-time feedback on new CAUTIs cases was provided to leadership at the daily safety briefs and to nurses and physicians at the unit-based huddles. The number of CAUTIs and “days without a CAUTI” was shared with team members via small posters and whiteboards.ResultsA statistically significant decrease in utilization of urinary catheters was observed (Table 1). Both hospitals and their respective ICUs remained CAUTI free for >12-consecutive months (Figure 1).ConclusionEliminating CAUTIs for 12 consecutive months in acute care community hospitals is possible and serves as a step toward the journey to zero harm. Reducing catheter utilization is a key strategy. Humanizing each infection and providing real-time feedback to the frontline staff and leadership in whole numbers (instead of the old paradigm of reporting CAUTI rates) may have resulted in greater engagement. Disclosures All Authors: No reported Disclosures.