Reinforcing a Catheter-Associated Urinary Tract Infection (CAUTI) Bundle Compliance Decreases Overall Catheter Days and CAUTIs

Abstract

BACKGROUND Catheter-associated urinary tract infections (CAUTI) are the most common type of healthcare-associated infection. The key risk factor for CAUTIs is prolonged indwelling catheter use, and therefore their use should be minimized when possible. The objectives of this initiative were to decrease CAUTIs by reinforcing bundle compliance and to decrease the use of indwelling catheters by utilizing more external catheters. METHODS Intervention began January 2017 when a bundle device compliance form with a daily catheter goal was introduced. This form ensured that proper procedures were followed, with a focus on the pericare process, with the most important step being the glove change after wiping the patient and prior to wiping the catheter. Bundle compliance was reviewed daily by unit managers and checked weekly by infection control, which resulted in an increase in bundle compliance, however the daily catheter goal was still not met. In January 2018 an external female catheter was introduced, and in June 2018 another type of external male?catheter was introduced in order to meet the daily catheter goal. RESULTS During the pre-intervention period (2016) a total of 32 CAUTIs were reported with 19,890 catheter days. Implementation of bundle compliance in 2017 led to a 9.3% reduction in CAUTIs and a 7.5% reduction in catheter days. Introduction of external catheters during 2018 further improved these numbers, leading to a total reduction of 59.3% in CAUTIs and 26.5% in catheter days compared to the pre-intervention period. CONCLUSIONS This initiative demonstrates that reinforcing bundle device rounds leads to moderate reductions in CAUTIs and catheter days. The initiative also showed that increased use of external catheters leads to even larger decreases in CAUTIs and catheter days. Implementing both of these measures met the goals for reductions in CAUTIs and catheter days and has led to an increase in patient safety.