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Catheter Associated Urinary Tract Infections (CAUTI)

A urinary tract infection is an infection that can occur in the kidneys, in the tubes that take urine from the kidneys to the bladder, or in the bladder.  An indwelling urinary catheter is a tube placed inside the bladder that drains urine to a bag outside the body.  Some patients need urinary catheters to help monitor and treat certain conditions; for example, patients who are critically ill and require close monitoring, patients who are recovering from surgery and patients who cannot pass urine.  Patients who have indwelling urinary catheters are more likely to get a urinary tract infection.

JFK uses evidence based best practices to reduce the chances of CAUTI.  Interventions to reduce CAUTI include maintaining aseptic technique when inserting a catheter, using a separate emptying container for each patient, and using a device to secure the catheter tubing to a patient’s leg.  In addition, each day the nursing staff reviews the need for the catheter on every patient and discusses removal with the physician when the catheter is no longer needed.

What are we measuring?

The rate of patients with catheter associated urinary tract infections in the critical care units (ICU and CCU).

Note: Hospitals and other websites use different ways to calculate rates. We calculate rate using 1000 catheter days as the denominator.

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What is our performance telling us?

This graph shows the occurrence of CAUTI over time on a downward trend.  Although the overall trend line continues downward, there is an increase beginning the first quarter of 2014.  We take this very seriously because our goal is to eliminate CAUTI.   We are using 2015 best practice guidelines to improve our processes as we continue to work to eliminate CAUTI.  For example, every day the nurses and physicians discuss whether the catheter can be removed.   In addition,  we review each CAUTI individually to determine the cause and identify ways to further reduce CAUTI.

CAUTI rates may be reported on public websites such as Hospital Compare; different time frames for reporting data can show different rates of CAUTI.

Removing Urinary Catheters After Surgery

Some surgical procedures require the placement of a urinary catheter.  In many instances the catheter can be removed on day one or day two after surgery.  This is important because urinary catheters put patients at risk for catheter associated urinary tract infections (CAUTI), are uncomfortable, and can restrict a patient’s movement. Our goal is to remove urinary catheters by the second post operative day as indicated by the patient’s condition.

Interventions to remove urinary catheters post operatively as soon as possible include nurse reminders to physicians to discontinue the catheter as soon as possible after surgery.

What are we measuring?

The graph below shows sustained improvement in the percentage of time these catheters are removed.   It means that our patients consistently have their urinary catheters removed as soon as possible. This decreases the risk for CAUTI.

This measure is also reported on public websites such as Hospital Compare.  Different time frames for reporting data may show different percentages.

 

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What is our performance telling us?

Throughout 2013 and 2014 we have measured 100% compliance.  We are no longer measuring this in 2015.

What can you do to prevent a CAUTI?

  • If you do not see your providers clean their hands, please ask them to do so.
  • Always keep your urine bag below the level of your bladder.
  • Do not tug or pull on the tubing.
  • Do not twist or kink the catheter tubing.
  • Ask your healthcare provider each day if you still need the catheter.

http://www.cdc.gov/hai/pdfs/uti/CA-UTI_tagged.pdf