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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 use different ways to calculate rates. We calculate rate using 1000 catheter days as the denominator.

cuati-2014-02

What is our performance telling us?

This graph shows the occurrence of CAUTI continuing on a downward trend.  Although the trend line continues downward, our goal is zero CAUTIs.  We take this very seriously and are using best practices to eliminate CAUTI.  For example, every day the nurses and physicians discuss whether the catheter can be removed.

Our goal is to eliminate all CAUTIs, so we review each CAUTI individually to determine the cause and identify ways to 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 improvement in the percentage of time these catheters are removed.  It means that more patients have their urinary catheters removed as soon as possible which 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.

urinarycath-2014-02b

What is our performance telling us?

We are pleased that for a full year from quarter 4 2012 through quarter 3 2013 all surgical patients’ urinary catheters were appropriately removed by the end of the second day after surgery.  Our goal is to reach 100% every quarter, for every surgical patient.