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CAUTI Content Call #6 A Hospital’s Perspective CAUTI Prevention: Implementation in a Community Hospital 1.

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Presentation on theme: "CAUTI Content Call #6 A Hospital’s Perspective CAUTI Prevention: Implementation in a Community Hospital 1."— Presentation transcript:

1 CAUTI Content Call #6 A Hospital’s Perspective CAUTI Prevention: Implementation in a Community Hospital 1

2 2 CUSP/CAUTI Content Call #2 - The Science of Safety Moderator – Sam Watson; Speaker – Sean Berenholtz 03/22/112 ET/1 CT/12 MT/11 PTAttendee: (866) Min. CUSP/CAUTI Content Call #3 - Care and Removal Intervention Moderator – Sam Watson; Speaker – Mohamad Fakih 04/05/112 ET/1 CT/12 MT/11 PTAttendee: (866) Min. CUSP/CAUTI Content Call #4 - Data Collection Moderator – Sam Watson; Speaker – Sam Watson 04/19/112 ET/1 CT/12 MT/11 PTAttendee: (866) Min. CUSP/CAUTI Content Call #5 - The View from the Bedside Moderator – Sam Watson; Speaker – Russ Olmsted 05/03/112 ET/1 CT/12 MT/11 PTAttendee: (866) Min. CUSP/CAUTI Content Call #6 - Implementation in a Community Hospital Moderator – Sam Watson; Speaker – Mary Jo Skiba 05/17/112 ET/1 CT/12 MT/11 PTAttendee: (866) Min. CUSP/CAUTI Content Call #1 – CUSP Moderator – Sam Watson; Speaker – Sean Berenholtz 03/07/112 ET/1 CT/12 MT/11 PTAttendee: (866) Min. CAUTI Content Call Schedule

3 CAUTI Prevention Implementation in a Community Hospital Mary Jo Skiba RN BSN Project Manager QI/Research January

4 146 Licensed Beds Med Surg (2 Units) ICU (8 Bed) Women’s Health Inpatient Rehab Inpatient Psych Non-Profit Sole Community Provider Community Hospital 4

5 Remove barriers and identify steps towards successful CAUTI project initiation Demonstrate educational strategies Maintain success Objectives 5

6 Plan, Plan, Plan… then Plan some more… Have a Plan 6

7 CAUTI Team Policies Awareness Campaign Data Collection Plan Project Start Date Education Plan for Follow-Up Project Planning 7

8 Establish CAUTI Team Members Involve frontline staff Have a physician champion Include charge nurses Include staff development Determine the scope of your initial project Policy - Urinary Catheterization Review/Revise Use policy in toolkit Don’t re-create the wheel Consolidate into one policy if possible Automatic Catheter Stop Policy 8 Project Planning

9 Hospital Newsletter Flyers Screen Savers KEYSTONE HAI (Hospital Associated Infections) “Bladder Bundle Project” Preventing Catheter Associated Urinary Tract Infections 9 Project Awareness

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12 Data Collection Data collectors Data forms – Add qualifiers specific to your hospital Assure understanding of project requirements 5 days week =Mon thru Fri (not W/E) Data entry web-based program 12

13 Project Start Date Use calendar or Gantt chart to plot activities Check vacation schedules of key staff Watch out for major holidays Be Flexible 13

14 Planning Education Nursing Who will be trained Who will train How will we train When will we train How will we do make-ups How much ongoing training or re-training needed Physicians Who will train How will we train When will we train 14

15 Two Fold Approach 1.Didactic CAUTI Face to Face Inservice All Nursing/Aides Guideline For Prevention of CAUTI Physician CME Dept Meetings 2. Demonstration of Insertion Competency 15

16 Developing CAUTI Education Don’t Re-create The Wheel Use Other Hospitals PowerPoint Slides Update/Revise to Fit Jerri’s Story North Carolina Prevent CAUTI Toolkit 16

17 Trained the trainers 17

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19 Urinary Catheter Insertion Competency Traveling Mannequin 100% Aides and all nurse frequent inserters (ED, OR, WHU, IP Rehab, ICU) Read Policy Take Quiz Perform Procedure Instant Remediation and Repeat Demonstration 19

20 167 Competencies Avg 15 min/staff member 41 Aides, 126 Nurses 20

21 Improper Cleaning26 Improper Gloving24 Contaminated field45 Didn’t know needleless cath port for specimens 30 Outcome 21

22 Urinary Catheter Insertion Competency Improvement Plan Require Field Competency all Aides within 2 months - supervised by RN’s Newly hired Aides trained by RN’s Yearly Aide hands on demonstration of competency 22

23 Strategies Caths flagged with date of insertion Secured to legs Specimen collection for culture - Don’t use first urine drained from catheter - ED patients – prior to collection, change catheter unless known change within 7 days - Inpatients… If catheter in for 7 days must change prior to specimen collection Perineal hygiene prior to caths “John Door” educational posters 23

24 Foley Catheter Prevalence 24

25 1/1/ /30/2008 ARMC Keystone Center for Patient Safety and Quality Comparative Data Units Data PointNumDenPrevelance Rate ReportingNum DenPrevelance Rate Pre , Int , Int , Post , ,69114, /1/08 –4/30/08 ARMC Michigan 25

26 Outcomes ARMC Monthly Urinary Cath Related UTI’s CAUTI’s Avg 3.8 mo CAUTI’s Avg 2.7 mo CAUTI’s Avg 2.3 mo CAUTI’s Avg 0.5 mo 26

27 Outcomes ARMC Monthly Urinary Cath Related UTI’s CAUTI’s Avg 3.8 mo CAUTI’s Avg 2.7 mo CAUTI’s Avg 2.3 mo CAUTI’s Avg 0.5 mo 27

28 Investigation Cath competency plan not followed Focus was on hospital EMR implementation Daily cath patrol not consistent Prevalence rates up 28

29 New Plan Annual competency aide and ED/OR nurses Competency imbedded in orientation/annual skills evaluation Agenda item every leadership/staff mtg Charge nurses do daily Cath Patrol- Med Surg Metric reports monthly to staff and physicians Cath necessity built into EMR documentation Decrease size standard cath from #16 to #14 29

30 Outcomes ARMC Monthly Urinary Cath Related UTI’s ZERO!! 30

31 Be vigilant…Plan for and carry out follow-up interventions Don’t worry alone… “Courage is being scared to death, but saddling up anyway” (John Wayne) Questions? 31 Questions

32 Your Feedback is Important


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