In 2022, the ICU CUSP (Comprehensive Unit-based Safety Program) Committee conducted a meeting centered on addressing the 2022 catheter-associated urinary tract infection (CAUTI) rate and analyzing a CAUTI case identified in July 2022. The team conducted a thorough chart review to identify gaps and opportunities for improvement. Key findings included:
- Inconsistent Documentation: Daily necessity documentation for the catheter was incomplete.
- Missed Care Opportunity: One instance of missed catheter care was noted.
These insights informed the development of an action plan designed to enhance CAUTI prevention practices. The CUSP team established a comprehensive strategy, emphasizing the reinforcement of existing practices and introducing targeted improvements:
- Multidisciplinary Rounds:
- Morning rounds include the interprofessional care team: ICU physician, primary nurse, respiratory therapist (RT), occupational therapist (OT), and physical therapist (PT).
- The primary nurse reviews patient lines, prompting discussion of necessity, including for indwelling urinary catheters.
- The team prioritized daily assessments and timely removal of Foley catheters.
- High-Risk Patient Review Process:
- Introduction of a practice change to identify high-risk patients for hospital-related infections, including CAUTI.
- Criteria included: indwelling lines/catheters, ICU length of stay, and comorbidities.
- Assistant nurse managers reviewed these criteria daily to identify prevention opportunities, with findings communicated to the clinical nursing team.
In late 2022, the CAUTI reduction action plan was presented to the ICU department highlighting the reduction strategies developed collaboratively by the interprofessional team. The practices have been maintained since and following the introduction of the CUSP-driven strategies, the KP SRO ICU has not had a CAUTI for over 857 days (as of December 1st, 2024).
The initiatives demonstrate KP SRO’s dedication to improving patient outcomes through evidence-based practice, multidisciplinary collaboration, and continuous learning. These efforts reflect a proactive approach to enhancing patient safety and quality of care.