With a sustained , interprofessional approach to infection control , achieving and maintaining zero CAUTI and CLABSI infections is possible .
Healthcare leaders must champion these infection control efforts at the highest levels of the organization to remove obstacles and empower frontline staff .”
CAUTI Infection Control Interventions :
Figure 2 : Tiered Approaches to Reducing CAUTI
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Source : AHRQ Safety Program for Intensive Care Units : Preventing CLABSI and CAUTI
Figure 3 : Tiered Approaches to Reducing CLABSI
Click to View Figure 3
Source : AHRQ Safety Program for Intensive Care Units : Preventing CLABSI and CAUTI
Regardless of the infection type , there are some important commonalities in reducing the incidence of CLABSI and CAUTI . These strategies can not only reduce the risk for infections but can also improve overall patient safety and reduce the length of stay :
●Improve communication patterns and unit culture relative to urinary catheter use
●Increase nurse comfort with urinary catheter removal protocols ●Improve staff knowledge and skills ●Create respect among nurses and providers ●Dedicate personnel to review , remind , and reinforce best practices and analyze infection rates ●Use the AHRQ Safety Program Playbook for
Intensive Care Units : Preventing CLABSI and CAUTI ●Utilize information technology support for data collection ●Provide feedback using data on catheter use to frontline staff ●Celebrate the ICU team ’ s recognition of the hazard of urinary and central venous catheters
Frontline staff plays a pivotal role in the success of any infection control intervention , but building staff competency in the proper placement , maintenance , and removal of indwelling urinary and central venous catheters . To build competency , the established competencies should be role-specific to the individual clinician type performing the care such as a registered nurse or nursing assistant . Healthcare facilities should identify what an employee ’ s role will be related to urinary catheters ( insertion , maintenance , transport of patients with urinary catheters , etc .). Then , there should be education and competency are offered to those with the responsibility of insertion . Finally , infection preventionists , unit managers can educate employees on hospital policies , procedures , and expectations for performance .
Sharing data about CAUTI and CLASBI back to frontline staff in real-time can optimize the appropriate use and care of indwelling catheters . This feedback encourages the use of alternatives to catheters , which can greatly reduce the risk of infection and mitigate the risk of future CAUTIs . Strategies to feed data back to staff include but are not limited to multidisciplinary catheter rounds with real-time feedback , and an in-depth review of CAUTIs to identify contributing factors to the infection .
With a sustained , interprofessional approach to infection control , achieving and maintaining zero CAUTI and CLABSI infections is possible . Healthcare leaders must champion these infection control efforts at the highest levels of the organization to remove obstacles and empower frontline staff . At every step on the infection journey , there are opportunities for improvement and together healthcare professionals can solve this ongoing patient safety threat .
J . Hudson Garrett Jr ., PhD , MSN , MPH , MBA , FNP- BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , BC-MSLcert™ , NCEE , NREMT , MSL-BC , DICO-C , TR-C , CPPS , CPHQ , CPXP , FACDONA , FAAPM , FNAP , FSHEA , FIDSA , is president and CEO of Community Health Associates , LLC . He also serves as an adjunct assistant professor of medicine in the Division of Infectious Diseases at the University of Louisville School of Medicine , is a fellow with the Institute for Healthcare Improvement , and has earned designation as a fellow with both the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America . Garrett is a frequent lecturer globally on patient safety , infectious diseases , and medical device reprocessing and safety . He may be reached at :
Hudson . garrett @ chaassociates . com
References
1 . Catheter-associated Urinary Tract Infection ( CAUTI ). Centers for Disease Control and Prevention .
2 . Ziegler MJ , Pellegrini DC , Safdar N . Attributable mortality of central line associated bloodstream infection : systematic review and meta-analysis . Infection . 2015 Feb ; 43 ( 1 ): 29-36 . Epub 2014 Oct 21 . doi : 10.1007 / s15010-014-0689-y . PMID : 25331552 .
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