Chasing Zero. Reducing Hospital Acquired Conditions in the Intensive Care Unit

2.50
Hdl Handle:
http://hdl.handle.net/10755/601473
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Title:
Chasing Zero. Reducing Hospital Acquired Conditions in the Intensive Care Unit
Author(s):
Johnson, Kelly; Mendoza, Cora; Rosenbush, Kristin; Rivera, Lorena
Lead Author STTI Affiliation:
Non-member
Author Details:
Johnson, MN, RN, CEN; Cora Mendoza, MSN, RN, CCRN; Kristin Rosenbush, MSN, RN, CCRN; Lorena Rivera, MSN, RN
Abstract:
Background: Catheter-Associated Urinary Tract Infections (CAUTI) are the most commonly reported hospital-acquired condition, and the rates continue to rise. More than 560,000 patients develop CAUTI each year, leading to extended hospital stays, increased health care costs, and patient morbidity and mortality.

Purpose: There was an increased incidence of CAUTI in the intensive care units as noted by Infection Prevention. The goal was to decrease CAUTI rates to below the NDNQI mean (<1.19) by September 2015.

Methods: There are three areas to improve evidence-based clinical care to reduce the rate of CAUTI: (A) prevention of inappropriate short-term catheter use, (B) nurse-driven timely removal of urinary catheters, and (C) urinary catheter care. Nursing screening and assessment and evidence-based management of urinary retention and incontinence is essential to reduce catheter overuse. The intensive care units adopted the American Nurses Association evidenced-based tool that incorporates an algorithm to determine if a urinary catheter is appropriate based on nursing screening and assessments, as well as alternatives for retention and incontinence; timely removal; and a checklist on catheter insertion, cues for essential maintenance and post-removal care.

The specific initiatives that were implemented were:

1. Daily foley rounds by a multi-disciplinary team

2. Standardization of the foley kit between ED/OR/ICU as patients were arriving without urometers and necessitating breaking the seal and replacing the collection bag.

3. Isolating foley catheter care with the use of “M-Care” wipes

4. Elimination of unnecessary urine cultures via a prompt within the EMR that reminds staff of the indications for urinary cultures.

5. Stabilization of catheter with “Stat-lock” device rather than an elastic strap which was causing migration of the catheter.

6. Working with transport technicians and educating them to empty the foley bag before the patient travels for procedure(s) outside of the ICU

7. Placing neon color stickers on the foley bag to serve as a reminder to all which read “keep bag below the bladder” particularly when patients were being ambulated.

Findings/Implications: Both the MICU and SICU had reductions in CAUTI incidence with a zero incidence of CAUTI as of 3Q15. CAUTI can be prevented through applications of evidence-based guidelines.

Keywords:
Hospital Acquired Conditions; Critical Care
Repository Posting Date:
17-Mar-2016
Date of Publication:
17-Mar-2016
Conference Date:
2016
Conference Name:
STTI Lambda Rho Chapter’s 2016 Nursing Research Conference
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing, Lambda Rho Chapter at Large
Conference Location:
Jacksonville, Florida, USA
Description:
Caring for a Diverse World

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.titleChasing Zero. Reducing Hospital Acquired Conditions in the Intensive Care Uniten
dc.contributor.authorJohnson, Kellyen
dc.contributor.authorMendoza, Coraen
dc.contributor.authorRosenbush, Kristinen
dc.contributor.authorRivera, Lorenaen
dc.contributor.departmentNon-memberen
dc.author.detailsJohnson, MN, RN, CEN; Cora Mendoza, MSN, RN, CCRN; Kristin Rosenbush, MSN, RN, CCRN; Lorena Rivera, MSN, RNen
dc.identifier.urihttp://hdl.handle.net/10755/601473en
dc.description.abstractBackground: Catheter-Associated Urinary Tract Infections (CAUTI) are the most commonly reported hospital-acquired condition, and the rates continue to rise. More than 560,000 patients develop CAUTI each year, leading to extended hospital stays, increased health care costs, and patient morbidity and mortality.</p><p>Purpose: There was an increased incidence of CAUTI in the intensive care units as noted by Infection Prevention. The goal was to decrease CAUTI rates to below the NDNQI mean (<1.19) by September 2015. </p><p>Methods: There are three areas to improve evidence-based clinical care to reduce the rate of CAUTI: (A) prevention of inappropriate short-term catheter use, (B) nurse-driven timely removal of urinary catheters, and (C) urinary catheter care. Nursing screening and assessment and evidence-based management of urinary retention and incontinence is essential to reduce catheter overuse. The intensive care units adopted the American Nurses Association evidenced-based tool that incorporates an algorithm to determine if a urinary catheter is appropriate based on nursing screening and assessments, as well as alternatives for retention and incontinence; timely removal; and a checklist on catheter insertion, cues for essential maintenance and post-removal care. </p><p>The specific initiatives that were implemented were: </p><p>1. Daily foley rounds by a multi-disciplinary team</p><p>2. Standardization of the foley kit between ED/OR/ICU as patients were arriving without urometers and necessitating breaking the seal and replacing the collection bag. </p><p>3. Isolating foley catheter care with the use of “M-Care” wipes</p><p>4. Elimination of unnecessary urine cultures via a prompt within the EMR that reminds staff of the indications for urinary cultures. </p><p>5. Stabilization of catheter with “Stat-lock” device rather than an elastic strap which was causing migration of the catheter. </p><p> 6. Working with transport technicians and educating them to empty the foley bag before the patient travels for procedure(s) outside of the ICU</p><p> 7. Placing neon color stickers on the foley bag to serve as a reminder to all which read “keep bag below the bladder” particularly when patients were being ambulated. </p><p>Findings/Implications: Both the MICU and SICU had reductions in CAUTI incidence with a zero incidence of CAUTI as of 3Q15. CAUTI can be prevented through applications of evidence-based guidelines.en
dc.subjectHospital Acquired Conditionsen
dc.subjectCritical Careen
dc.date.available2016-03-17T11:56:28Zen
dc.date.issued2016-03-17en
dc.date.accessioned2016-03-17T11:56:28Zen
dc.conference.date2016en
dc.conference.nameSTTI Lambda Rho Chapter’s 2016 Nursing Research Conferenceen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursing, Lambda Rho Chapter at Largeen
dc.conference.locationJacksonville, Florida, USAen
dc.descriptionCaring for a Diverse Worlden
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