1. Introduction to CAUTI and CLABSI Initiatives
May 2, 2012

2. Objectives
Goals, Objectives, and Measurement Strategy for CAUTI and CLABSI Initiatives
Conducting a Point Prevalence Study
CAUTI Initiative
CLABSI Initiative
Assessing Current Practices
September 21, 2018

3. CAUTI Initiative Goals
To reduce unnecessary catheter utilization.
To eliminate and sustain reductions in catheter- associated urinary tract infections.
September 21, 2018

4. CAUTI Initiative Objectives
By June 2012
Within First 6 Months
By November 2013
Implement the CAUTI bundle in the:
Emergency Department (ED);
In at least one high- utilization adult ICU, and;
In at least one high- utilization non-ICU unit.
Reduce catheter utilization in the ED, high-utilization ICU, and non-ICU by at least 10%.
Reduce CAUTIs in the high-utilization ICU and non-ICU by 20% or achieve a standardized infection ratio (SIR) of 0.8 or less.
Reduce catheter utilization hospital- wide by 15%.
Reduce CAUTIs by 40% or achieve a SIR of 0.6 hospital-wide.
September 21, 2018

5. CAUTI Measurement
Point-prevalence survey, hospital-wide, to determine units with high catheter utilization
Monthly data collection
Indwelling catheter days (NHSN)
CAUTI events in the intervention ICU(s) and non-ICU unit(s)
Documentation of appropriate indication for urinary catheter (# of patients on unit with urinary catheter for which there is an appropriate indication/# of patients on unit with urinary catheter.  Assessed at least one day per week)
Monthly calculations using data collected
Device utilization ratio (NHSN)
CAUTI rate in the ICU and non-ICU unit (NHSN)
SIR for CAUTI
Baseline and follow-up assessments to determine diffusion of the bundle
September 21, 2018

6. CLABSI Initiative Goals
To eliminate central line–associated bloodstream infections.
September 21, 2018

7. CLABSI Initiative Objectives
By June 2012
Within First 6 Months
By November 2013
Implement the CLABSI insertion bundle in the adult ICU setting.
Implement the CLABSI maintenance bundle in at least one adult ICU and at least one high-utilization adult non-ICU unit.
Reduce CLABSIs in the adult ICU setting by 30% or achieve a SIR of 0.7 or less.
Establish a baseline in at least one adult non- ICU unit.
Spread the CLABSI insertion and maintenance bundles hospital-wide.
Reduce CLABSIs by 50% or achieve a SIR of 0.5 or less hospital- wide.
September 21, 2018

8. CLABSI Measurement
Point-prevalence survey to determine non-ICU units with high central line utilization
Monthly data collection
Central line days (NHSN)
# of CLABSI events (NHSN)
Documentation of review of line necessity (# of patients on unit with central line for which there is documented review of line necessity/# of patients on unit with central line.  Assessed at least one day per week)
Monthly calculations using data collected
CLABSI rate (NHSN)
SIR for CLABSI
Baseline and follow-up assessments to determine diffusion of the bundle
September 21, 2018

9. Where do we start?
Determine which units at your hospital have the highest utilization of urinary catheters and central lines by conducting a point prevalence study.
Include:
Intensive Care Units
All General Medical Units
May also include surgical and rehab units
High utilization units identified through the point prevalence study or through other methods should be the focus of the CAUTI and CLABSI initiatives.
September 21, 2018

10. Procedure for Point Prevalence Study
Determine a week to conduct the prevalence study.
Recommended week for CAUTI & CLABSI initiatives: Week of May 14, 2012
Recommendation: complete the prevalence study within a narrow timeframe, preferably one to two days during that week.
Choose an approximate time within the day to conduct the procedure.
September 21, 2018

11. Procedure for Point Prevalence Study cont.
Calculate Point Prevalence on each unit, hospital-wide.
CAUTI: Urinary Catheters
CLABSI: Central lines
September 21, 2018

12. Personnel to Conduct Prevalence Study
Assign someone who is reliable and meticulous to count urinary catheters and central lines on each inpatient unit
Staff could include any of the following:
Infection Preventionist
Nurse Manager
Other identified personnel who can take the time to conduct the prevalence study during the specified timeframe
September 21, 2018

13. Data Collection: Important Elements
Date
Units
Number of patients at specific point in time on unit (census)
Number of patients with urinary catheters or central lines on unit
Calculation of prevalence rate(s)
September 21, 2018

14. Data Collection Example: Point Prevalence for Urinary Catheters and Central Lines
Hospital Name: St. Mary’s Hospital
Month: May 2012
Today’s Date: May 2, 2012
Data Collector: Michelle Smith
Time of Day: 9:45 a.m.
Unit
# of Patients (Census)
# of Patients with Urinary Catheters
Prevalence Rate
3 North 38 6
15.8%
5 South 24 9
37.5%
5 North 29 3
10.3%
# of Patients with Central Lines 2
5.3%
8.3% 4
13.8%
Out of these 3 units, 5 South has the highest prevalence of urinary catheters and 5 North has the highest prevalence of central lines.
September 21, 2018

15. Data Collection Tool Example
Hospital____________________________
Point Prevalence study for urinary catheters
MONTH
Data collector
today's date
Time
UNIT
# of Patients (Census)
# of Patients with Urinary Catheters
Prevalence
total
Taken from St. Luke’s Roosevelt Hospital Center
September 21, 2018

16. Next Steps
Conduct point prevalence study on units hospital- wide during the week of May 14, (recommendation to pick 1-2 dates).
Identify data collector(s).
Collect data.
Note: If your institution has already established a process to conduct a point prevalence study, please do NOT change your methodology.
Please continue to use your established procedures.
Contact your NYSPFP Project Manager with questions!
September 21, 2018

17. Assessment of Current Practices
Purpose
To identify current practices with regard to CAUTI and CLABSI monitoring and reduction
To guide targeted educational programming
To provide a baseline assessment for post-intervention comparison
Content
In addition to background information, each assessment addresses practices surrounding insertion, maintenance, and surveillance
Instructions
Complete one CAUTI and one CLABSI assessment per institution
If you have opted out of either CAUTI or CLABSI, it is not necessary to complete that assessment
The clinical and data leads for CAUTI and CLABSI should complete the assessments, with input from key team members as needed
Next Steps
Links to the assessments will be distributed electronically

18. Upcoming Events for CAUTI/CLABSI
CAUTI/CLABSI Kick-off Educational Webinar – May 24; 1:30 p.m. – 3:30 p.m.
CAUTI/CLABSI Regional Meetings – Dates TBD
September 21, 2018

19. Questions ?
September 21, 2018