Decreasing Catheter-Associated Urinary Tract Infection (CAUTI) at a community academic medical center using a multidisciplinary team employing a multi-pronged approach during the COVID-19 pandemic

Abstract

In the midst of the COVID - 19 pandemic, a multidisciplinary team implemented evidence-based strategies to eliminate catheter associated urinary tract infections (CAUTI), as defined by the National Healthcare Safety Network (NHSN) surveillance definition for those units included in the NHSN standardized infection ratio. The team evaluated indwelling urinary catheters daily for indication, implemented a urinary catheter order set, established a urinary catheter insertion checklist, and promoted use of external urinary diversion devices. The facility NHSN standardized infection ratio for CAUTI was 0.37 in 2019, 0.23 in 2020, and 0.00 in 2021. A collaborative approach decreasing hospital acquired infections may be effective even in a climate of increased acuity, increased length of stay, and staffing challenges.

Keywords: External urinary diversion device; Hospital Acquired Infection (HAI); Indwelling Urinary Catheter (IUC); National Healthcare Safety Network (NHSN); Standard Utilization Ratio (SUR); Standardized Infection Ratio (SIR).

Graphical abstract

Fig 1

Nurse-driven indwelling urinary catheter removal protocol. IUC appropriateness was emphasized prompting removal when criteria weren't met.

Fig 2

Indwelling urinary catheter insertion checklist used bedside during placement of IUCs. This is used at the bedside by a second RN in order to improve aseptic insertion.

Fig 2

Indwelling urinary catheter insertion checklist used bedside during placement of IUCs. This is used at the bedside by a second RN in order to improve aseptic insertion.

Fig 3

Foley days verses external diversion devices used from December 2019 to December 2021. This graph demonstrates trending of increased usage of external urinary diversion devices.