Reduction in Catheter Associated Urinary Tract Infection Rates and Device Utilization in a Medical Unit and a Respiratory Stepdown Unit

Abstract

Among urinary tract infections acquired in the hospital, approximately 75% are associated with a urinary catheter. The lack of a framework for daily inter-disciplinary communication of catheter necessity and the monitoring of maintenance bundle practices can lead to prolonged catheter utilization that results in an increased risk for catheter associated urinary tract infections (CAUTIs). The objective of this project is to demonstrate that the daily use of effective communication strategies and monitoring tools will decrease CAUTI rates and device utilization on both a medical and a respiratory step down unit. We chose a medical unit and a pulmonary step down unit that had fluctuating CAUTI rates, standardized infection ratios (SIR), and device utilization rates prior to the start of this study. Patients with indwelling urinary catheters on each of these units were followed on a daily basis for a period of one year. All rates, SIRs, and percentiles were compared to NHSN benchmarks using the “Rate Table for Catheter-Associated UTI Data” and the “SIR for All Catheter-Associated UTI Data” in NHSN. A year's data was analyzed for this study. SIRs, infection rates and device utilization ratios were calculated and compared to the results of the same NHSN analysis performed for these units for the baseline year prior to the start of the project. Please see Table 1. We found that the implementation of daily interdisciplinary communication strategies and bundle monitoring tools led to a decrease in CAUTI rates, SIRs, and device utilization on both units. Tools that guide health care providers to ensure compliance with maintenance bundles and removal of urinary catheters in a timely manner leads to the prevention of CAUTIs in hospitalized patients.