ABHB Interventions aimed at reducing - CAUTI (Catheter Associated Urinary Tract Infection).

Background Urinary Tract Infections (UTI) are one of the most common Health Care Associated Infections Urethral catheters alter the body’s natural defence mechanism and provides constant portal. Chance of CAUTI increases with the longer the catheter is in situ (approx. 5% per day) CAUTI contributes to increased morbidity, mortality, prolonged hospital stays, financial costs, plus pain and distress for patients.

Current Situation Documentation/ Evidence surrounding the standard of catheter care we provide is poor or missing Infection rates are unclear An All Wales steering group are reviewing methods of sharing best practice and providing a consistent standard.(95%)

Potential Care bundles linked to urethral catheter care. A package of individual actions or behaviours that when linked together, for a specific clinical practice, can increase effectiveness and improve outcome Insertion bundles Maintenance bundle Specimen collection bundle.

Considerations & Choices Insertion v’s maintenance Data collection v’s paper collection Processes and outcome measurements

Standard for maintenance Care Bundle to reduce CAUTI Element 1 Catheter Stand: A catheter bag stand must always be used. The bag should be placed lower than the bladder but have no contact with the floor. Element 2 Personal Protective Equipment When empting catheter bags, PPE (gloves and aprons) should be worn. A visor should be used if chance of splashing. Remember: Hand hygiene is required before and after glove use. Element 3 Clean Receptacle A clean receptacle must be used every time a catheter bag is emptied.. Element 4 Empty at least daily/ or as required Catheter bags should be emptied at least daily or as required -dependant on patients condition or monitoring processes. Each break of the circuit presents Cross infection opportunities. Record emptied measured output in daily TCAB/ or equivalent Element 5 Catheter Toilet /wash Daily cleaning of meatus and catheter with soap and water reduces potential for infections to pass up outer coating of the catheter. Please document daily in TCAB/ or equivalent when catheter toilet is preformed by patient or staff Element 6 Continued need for catheter Please regularly document in TCAB, the medical/ nursing assessment stating why the catheter is still needed. Include assessment and review date.

Monitoring Tool One tool to incorporate all components of bundle Could indicate the repetition and sustainability of compliance of care bundle throughout a ward. Simple to use- capturing compliance, with a scoring capability for individual elements and the bundle as a whole. Includes assessment of knowledge Familiar audit format ( hand hygiene)

Maintenance – monitoring tool.. Location: Time: Maintenance – monitoring tool..

How did they do?

Prevalence Survey Monthly: All patients with urethral catheters insitu for more than 48hours will be reviewed via: Notes Antibiotic therapy Observation charts Correlation with CAUTI specifications and definitions will be made and outcome rates established

Outcome measurements. in infection rates in number of catheters cared for in number days of catheter.

Any Questions or Suggestions