LAUSR

Background Urinary Tract Infections (UTIs) are a common Healthcare Associated Infection (HAI) with the majority of infections occurring after the insertion of a urinary catheter. Urinary catheters are frequently used during inpatient stays, although convenient the catheters are uncomfortable and sometimes unnecessary. There is significant morbidity and cost associated with CAUTIs. Methods In 2016, 93 CAUTIs were reported into the National Healthcare Safety Network (NHSN). This number was deemed to be unacceptable by the facility. A CAUTI team was assembled with leaders from Infection Prevention, Nursing, and Performance Improvement. The objective was to develop a sustainable system to reduce CAUTIs that could be implemented across all services at the facility. The CAUTI team developed Specific, Measurable, Actionable, Relevant, and Timebound (SMART) Aims to reduce the number of CAUTIs. Unit based champions were selected from all 26 units and weekly meetings were held to discuss data, goals, and to educate on CAUTI reduction methods. The following initiatives were implemented: daily review of all catheters, introduction of an external female catheter, development of a bladder scanning protocol, weekly audits of units, and reviews of all CAUTIs. Results In 2016, 96 CAUTIs were reported into NHSN. In the first three quarters of 2019, 36 CAUTIs were reported into NHSN. There has also been a significant reduction in urinary catheter days. In 2016, 35,694 catheter days were entered into NHSN. In the first three quarters of 2019, 19,936 catheter days were entered into NHSN. Conclusions The reduction in CAUTIs at the facility was statistically significant. The reduction in catheter days was also statistically significant. The unit based champions became engaged in the CAUTI reduction initiatives and the culture of the facility began to change. The ultimate goal is zero CAUTIs and it is a possibility with engaged unit champions that became the driving force behind this initiative.