CAUTI team reduces infections and catheter use
A diverse, multidisciplinary team across Monument Health collaborated to reduce the number of catheter-associated urinary tract infections (CAUTI) at Rapid City Hospital by 50 percent over the last two years. The team also reduced infections at all other Monument Health hospitals, as well as drastically reduced the use of catheters overall. The CAUTI team won this quarter’s Quality Showcase award for the undertaking.
Angie Dahlke, Director of Nursing for the Sturgis Market, was co-chair of the project. She said the project’s success has a lot to do with its dynamic team, which includes nursing leaders, infection control, frontline caregivers, nurse educators and more. “It’s been a diverse team looking at it from many different angles. Nursing leaders have been instrumental in ensuring that best practices have cascaded throughout our environments.” She added that when deciding to take on a project that involves so many people, communication is vital, and the goals have to “invade the culture.”
Reducing CAUTI can significantly reduce costs and patient length of stay. According to the Centers for Disease Control and Prevention, urinary tract infections are the most common type of health care-associated infection reported, and most of them involve a urinary catheter.
Monument Health’s team followed the Institute for Healthcare Improvement’s (IHI) four components of quality care as a model to identify strategies to reduce both catheter use and infection rates. The four components include: 1) Avoid unnecessary urinary catheters, 2) insert catheters using the aseptic technique, 3) maintain catheters using recommended guidelines, and 4) review catheter necessity daily and remove them promptly.
Nursing caregivers partnered with Bard Medical, Monument Health’s catheter vendor, to complete a full assessment of current practices and receive thorough education regarding best practices. This review resulted in the introduction of new external catheters for both men and women. The team met monthly to review data from the infection control caregivers regarding CAUTI and catheter use and discuss strategies to implement IHI’s recommendations. The team also helped standardize products across Monument Health, developed an insertion competency program and created a case review process to be followed for every CAUTI.
Chris Meier, Nursing Professional Development Practitioner and member of the CAUTI team, said the project has been successful overall because the team has followed evidence-based practice guidelines and was able to standardize care delivery. He added that, “All of these efforts were due to members of the team keeping an open mind about what is possible.”
While the team’s work has paid off, Angie notes that the team’s work will never be done. “As long as we’re using catheters, there’s going to be a risk to our patients. It takes constant diligence. You can’t take your eye off that end goal for one second. We need to make sure we’re thinking about these things at every level, all the time.” Since the team’s inception in 2015, the Hills Markets have seen zero CAUTI incidents.
Congratulations to the CAUTI team for continuing to tackle this challenge and putting our patients first.