Spotlight on Northeastern Health System’s CAUTI & Catheter Utilization Reduction in Medical ICU initiative

Posted on: 1/31/20


Each of the Excellence in Quality Award submissions will be featured in this column over the coming weeks to highlight and share successful quality initiatives. For each submission, we will describe how the problem was identified, the improvement goal(s), interventions and outcomes. Please feel free to utilize this information, duplicate interventions, and share with your staff.

Northeastern Health System, Tahlequah, received an Honorable Mention for their CAUTI & Catheter Utilization Reduction in Medical ICU initiative submitted by Julie Jordan, AVP of quality, safety & accreditation.

Identifying the Problem: The hospital’s CAUTI rates were significantly elevated compared with the state peer group; high CAUTI rates were related to both high Foley utilization and inconsistencies with placement techniques and catheter care and were associated with long-stay patients.

The Goal: Decrease CAUTI rates to within or below the project and peer average by January 2020; decrease Foley utilization through reinforcement and education of standardization of insertion techniques and Foley catheter care best practices.

Interventions:  
  1. A multidisciplinary team was developed.
  2. A catheter supplier was engaged for a facility assessment (findings: inconsistencies with catheter insertions and catheter care).
  3. Nurse-driven protocol for prompt catheter removal developed/passed by medical committee.
  4. Medical ICU champion identified who educated staff on current data and project goal.
  5. External female catheter approved for use in hospital and later deployed in nursing departments.
  6. Annual nurse competency education/training included nurse driving protocol, external female catheter, appropriate utilization of peri-wipes, and proper Foley insertion.
  7. Participated in AHRQ Patient Safety ICU CAUTI/CLABSI initiative with OHA.
  8. Infection control officer began daily rounds.
The Outcome: This unit sustained a zero CAUTI rate from October 2018 to May 2019. The catheter utilization rate is continuing a downward trend (and utilization decreased 20% by May 2019). Nurses are empowered to initiate a catheter removal protocol. There is an increased usage of external catheters for both male and female patients and an increased utilization of a bladder scanner/straight catheter use prior to placement of an indwelling catheter.

Comments: This unit experienced improved medical ICU staff and attending physician communications and also professional accountability towards a shared goal.