1. Robin Haag, RN, BC, MA Director Infection Control/Prevention & HIV Services

2. Bundle Approach  Structured way of improving the processes of care and patient outcomes  Straightforward set of evidence-based practices  When performed collectively have been proven to improve patient outcomes

3. CAUTI Prevention Bundle  Catheter insertion using sterile technique Written order for catheter that includes justification Automatic stop order at 48 hours Daily review of catheter necessity Tamper evident seal unbroken (closed system) Drainage bag lower than patient’s bladder Bag and tubing above the floor Catheter secured to leg  Free flow of urine Linen clip Tubing not kinked or dependent  Daily description of urine  Remove catheter from patient’s with UTI  Daily peri-care and after each bowel movement  Patient specific urinal for bag drainage Urinal cleaned after each use  Hand hygiene before and after touch any part of a urinary drainage system

4. PI Bundle Tool

5. Check Check Check Check Check

8. Corrective Actions  Device Prevalence  Bundle Rounds Every Day Every Shift  Interdisciplinary rounds Assess Need for Catheter Active Order List ○ HNs ○ Nursing Directors ○ Providers

10. Education  Round the Clock Actual Data Prevention  Competencies Nursing Providers ○ Doctors Housestaff ○ PAs ○ Medical Students  Insertion Observation Form

14. For the Future  Ongoing competencies  Bundle PI  Insertion observation  Hospital wide bladder scanning  Only nurses inserting ???  Mini-RCAs for CAUTIs Unit Level Accountability ○ Closing the loop ○ Report in Department PI meetings ○ Report to IC/IP meeting

15.  Robin Haag  (718) 616 - 3106  haagr@nychhc.org