Small Patients and Tiny CAUTI Rates: Sustained CAUTI Reduction in a Children's Hospital

Abstract

<h3>Background</h3> The pediatric catheter associated urinary tract infection (CAUTI) prevention team was formed in August 2015 to address a patient safety need. CAUTI rates, specifically in the pediatric intensive care unit (PICU), was consistently above national benchmarks, resulting in unnecessary harm to patients. <h3>Methods</h3> The CAUTI prevention team is a multidisciplinary team made up of bedside staff, physicians, and specialists. The team discusses metrics, bundle compliance and new products, and makes recommendations for Foley use and care. Education is provided regularly to bedside staff and physicians, with real time notification of CAUTI events. Since the development in 2015, the team has been able to move from general CAUTI education to specific and targeted reduction tactics. The team provides real-time notification to bedside staff to discuss Foleys in place greater than 2 days in order to facilitate removal. The team also provides weekly personalized utilization rates to ICU physicians for their own trending. Additionally, the team has expanded standardized patient bathing across the hospital, and developed tools for decreased discomfort and anxiety during catheterization processes. <h3>Results</h3> Since the team was formed in 2015, sustained improvement has been seen in CAUTI reduction with a 56% decrease hospital-wide and a 67% decrease specifically in the pediatric intensive care unit (PICU). Additionally, a process shift for Foley utilization in the PICU was seen in August 2016, and has been sustained to date. Prior to committee formation, Foley utilization was as high as 30%. In the last quarter, utilization averaged 10%, a 66% decrease. <h3>Conclusions</h3> The team has established, and more importantly sustained, standards for Foley use and care that have had significant impact on CAUTI rates in our hospital, preventing our patients from harm.