Jolene Smeltzer, RN, MSN, CNL
Registered Nurse
Torrance Memorial Medical Center, United States
Disclosure information not submitted.
Julie Che, RN MSN NEA-BC
Nursing Director
Torrance Memorial Medical Center, United States
Disclosure information not submitted.
Title: Reducing CAUTIs with a Novel Catheter Technology in the ICU
Introduction: Catheter associated urinary tract infections (CAUTI) are a serious problem that can lead to increased length of stay (LOS), cost, patient harm, and death. In 2019, poor performance in CAUTIs and other harm events contributed to a loss of approximately $800K in reimbursement to our institution. The impetus for implementing a device with novel technology to decrease infection stemmed from a retrospective analysis of the CAUTI rates, which showed higher than national benchmark levels at 2.09, 2.47, and 1.45 per 1000 catheter days in the first, second, and third quarter of 2020, respectively. Therefore, the goal of this study was to evaluate a new indwelling urinary catheter (IUC) with a novel technology of active drain clearance that prevents back flow and pooled urine in the bladder to reduce CAUTI rates.
Methods: A PDCA (Plan-Do-Check-Act) framework guided a unit-wide evidence-based practice change to decrease CAUTI rates by changing the current practice of using a standardized IUC to a novel device over two quarters. CAUTI rates per 1000/catheter days were capture for the standard and the novel technology during the study time period for the 48-bed ICU.
Results: From November 2020 to March 2021, there was a total of 428 standard catheters and 170 novel catheters placed. The CAUTI rate in standard catheters was 2.2 per 1000 catheter days. The CAUTI rate for the novel catheter during this same time period was 0/1000 catheter days.
Conclusions: Use of the novel catheter resulted in a reduction in CAUTIs with our lowest rate seen in the past 1.5 years. Though only 40% of catheter usage was with a novel device, future trials with investigations of CAUTI rates with 100% usage of novel technology are warranted to determine the full impact of a new device eliminating CAUTI’s in catheterized patients.