MP34-18 ONGOING EFFORTS AT MAINTAINING CATHETER-ASSOCIATED URINARY TRACT INFECTION BUNDLE PROVE TO BE EFFECTIVE: AN EIGHT YEAR EXPERIENCE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP34-18 ONGOING EFFORTS AT MAINTAINING CATHETER-ASSOCIATED URINARY TRACT INFECTION BUNDLE PROVE TO BE EFFECTIVE: AN EIGHT YEAR EXPERIENCE Joshua Altschuler, Olena Dzenkevych, Angela Gabasan, Barbara Smith, Nicholas Sells, Krystina Woods, and Jay A. Motola Joshua AltschulerJoshua Altschuler More articles by this author , Olena DzenkevychOlena Dzenkevych More articles by this author , Angela GabasanAngela Gabasan More articles by this author , Barbara SmithBarbara Smith More articles by this author , Nicholas SellsNicholas Sells More articles by this author , Krystina WoodsKrystina Woods More articles by this author , and Jay A. MotolaJay A. Motola More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003268.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of urinary tract infections and account for a major healthcare expenditure nationwide. The risk of CAUTI increases 5% with each day (d) of catheterization. For over a decade, we have implemented an evidence-based, joint commission and Centers for Disease Control approved CAUTI Bundle (CB). We seek to prove if after achieving low CAUTI rates in prior years if the manpower needed to do this is worthwhile. METHODS: We collected data from hospitals 1 and 2 (H1 and H2) in an urban healthcare system. Daily catheter (C) use and maintenance are monitored by a multidisciplinary hospital team. Compliance is determined by several factors: maintaining integrity of tamper-evident seal, keeping C bag below to gravity below bladder and off of floor, C secured to leg (no tape), labeled drainage bag, daily perineal care and daily C order renewal. We recorded device days (dd), utilization rates (dd/patient d) and standardized infection ratios (SIR). Non-compliance for C orders and C in > than 4 d in ICUs or >2 d in non-ICU were promptly addressed by hospital administration. RESULTS: Over the last 8 years, CAUTI rates have remained relatively stable. C utilization steadily increased between 2017 and 2021, plateauing this calendar year. SIR increased at H2 (Table 1), attributable to a busy cardiac surgery service that routinely uses C, in addition to an ever-growing population of nursing home patients with indwelling C. Figure 1 shows overall CB and C order compliance rates. Figure 2 shows compliance rates broken down by parameters of CB for H 1 & 2. CONCLUSIONS: As utilization rates have plateaued this calendar year, we have consistently sustained SIR<1 using our CB compliance model (CBCM) across multiple institutions with different cultures and practitioners. Efforts to further improve CAUTI incidence are ongoing with hospital-wide education programs teaching proper catheterization technique, device management and specimen collection. This study clearly demonstrates the benefits of maintaining the CAUTI bundle, and suggests that the resources required to maintain low infection rates may offset the non-reimbursable costs associated with CAUTI. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e466 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Altschuler More articles by this author Olena Dzenkevych More articles by this author Angela Gabasan More articles by this author Barbara Smith More articles by this author Nicholas Sells More articles by this author Krystina Woods More articles by this author Jay A. Motola More articles by this author Expand All Advertisement PDF downloadLoading ...