Implementation of Standardized Catheter Cleansing Cloths at an Inpatient Rehab Facility

Abstract

<h3>Background</h3> A higher than expected number of catheter-associated urinary tract infections (CAUTIs) was occurring at an inpatient rehab facility (IRF). Patients at IRFs often have indwelling urinary catheters (IUCs) for medical conditions like neurogenic bladder or urinary retention conditions. It is essential to provide consistent care and maintenance of IUCs for patients with long-term or chronic urinary catheters to prevent infection. Variability exists in the frequency, procedure, and availability of products for catheter care. <h3>Methods</h3> The quality improvement project, using lean methodology, took place over a six-month period at a 38 bed IRF to include patients with an IUC. The catheter cleansing cloths were used daily and as needed on patients with an IUC. The improvement project assessed if the daily use of the catheter cleansing cloths reduced the incidence of CAUTI at an IRF. A daily tracking tool was developed to monitor catheter device utilization and record daily documentation of urinary catheter care with the designated cleansing cloths. <h3>Results</h3> In the 12 months prior to the implementation of the catheter cleansing cloths, the IRF had seven CAUTIs. In the six months since the start of using the cloths, the IRF had zero CAUTIs. The Standardized Utilization Ratio (SUR) for the IRF in the six months prior to implementing daily device monitoring was 1.458. In the first six months of daily device monitoring, the SUR was 1.014. <h3>Conclusions</h3> The quality improvement project revealed a standardized process for daily catheter care is associated with a reduction in CAUTI. This project also notes an association between the daily monitoring of IUC devices and a reduction in catheter device utilization. Using catheter cleansing cloths for daily catheter care may be a great resource to provide consistent and predicable care for patients with IUCs.