Instituting a Quality Improvement Program at a Community Medical Designed to Reduce Urinary Catheter Days and the Incidence of Catheter Associated Urinary Tract Infections

6.00
Hdl Handle:
http://hdl.handle.net/10755/620869
Category:
Full-text
Format:
Text-based Document
Type:
DNP Capstone Project
Level of Evidence:
Other
Research Approach:
Translational Research/Evidence-based Practice
Title:
Instituting a Quality Improvement Program at a Community Medical Designed to Reduce Urinary Catheter Days and the Incidence of Catheter Associated Urinary Tract Infections
Author(s):
Davis, Minnie L.
Additional Author Information:
Minnie L. Davis DNP, MSN, RN, ARNP, AGPCNP-BC, NP-C, CWCN; contact email: minniedavis@hotmail.com
Advisors:
Runiwicz, Jo Ann; Roberts, Bridget; Herman, Joseph J.
Degree:
DNP
Degree Year:
2016
Grantor:
Capella University
Abstract:

Background: In the United States (US) it has been reported that approximately 40% of all healthcare-associated infections (HAIs) are indwelling urinary catheter associated. These infections give rise to increased morbidity, mortality, and result in increased healthcare costs (Nicolle, 2012). A northwest community hospital has identified a higher number of infections related to urinary catheter use and an excessive number of urinary catheter days as compared to the state average.
Purpose:
In an attempt to reduce the rate of catheter-associated urinary tract infections (CAUTIs) a quality improvement project involving the development of an evidence-based nurse-driven urinary catheter protocol (UCP) as well as ongoing educational efforts was instituted.

Method: Nursing staff reviewed catheter use daily and contacted physicians to discontinue urinary catheters based on the protocol. Education of nursing staff and patients in alternatives to catheter use and post catheter care were emphasized. All patients with urinary catheters were included in the quantitative analysis. Urinary tract infections were monitored by Infection Prevention through the review of all positive urine cultures and all physician diagnoses of urinary tract infection. Urinary catheter days were collected by nursing staff.

Results: Urinary catheter days were reduced from a three-month average of 2844 in the year before the intervention to 2361 in the three months after the intervention. The incidence of CAUTI was reduced by 67% with a resulting decrease in CAUTI rate from 3.79 to 1.30 infections/100 catheter days although the results were not statically significant (P=0.48).

Conclusion: The present study was limited due to time constraints and lacked statistical power but did appear to indicate that the use of a nurse-driven urinary catheter protocol may decrease the rate of hospital acquired CAUTI and warrants further ongoing study.

Keywords: Quality Improvement, Urinary Catheter Protocol, Catheter-Associated Urinary Tract Infection (CAUTI), Infection Prevention, Standard Infection Ratio (SIR), and Healthcare-Associated Infections (HAIs)

Keywords:
Catheter associated urinary tract infections; Urinary Catheter protocol; Healthcare associated infections; urinary tract infections
CINAHL Headings:
Urinary Tract Infections, Catheter-Related--Prevention and Control; Urinary Tract Infections, Catheter-Related; Quality Improvement; Urinary Catheterization; Cross Infection; Nursing Protocols--Evaluation
Note:
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Repository Posting Date:
2016-10-07T20:47:16Z
Date of Publication:
2016-10-07

Full metadata record

DC FieldValue Language
dc.contributor.advisorRuniwicz, Jo Annen
dc.contributor.advisorRoberts, Bridgeten
dc.contributor.advisorHerman, Joseph J.en
dc.contributor.authorDavis, Minnie L.en
dc.date.accessioned2016-10-07T20:47:16Z-
dc.date.available2016-10-07T20:47:16Z-
dc.date.issued2016-10-07-
dc.identifier.urihttp://hdl.handle.net/10755/620869-
dc.description.abstract<p><strong>Background:</strong> In the United States (US) it has been reported that approximately 40% of all healthcare-associated infections (HAIs) are indwelling urinary catheter associated. These infections give rise to increased morbidity, mortality, and result in increased healthcare costs (Nicolle, 2012). A northwest community hospital has identified a higher number of infections related to urinary catheter use and an excessive number of urinary catheter days as compared to the state average.<strong><br /> Purpose:</strong> In an attempt to reduce the rate of catheter-associated urinary tract infections (CAUTIs) a quality improvement project involving the development of an evidence-based nurse-driven urinary catheter protocol (UCP) as well as ongoing educational efforts was instituted.</p> <p><strong>Method:</strong> Nursing staff reviewed catheter use daily and contacted physicians to discontinue urinary catheters based on the protocol. Education of nursing staff and patients in alternatives to catheter use and post catheter care were emphasized. All patients with urinary catheters were included in the quantitative analysis. Urinary tract infections were monitored by Infection Prevention through the review of all positive urine cultures and all physician diagnoses of urinary tract infection. Urinary catheter days were collected by nursing staff.</p> <p><strong>Results:</strong> Urinary catheter days were reduced from a three-month average of 2844 in the year before the intervention to 2361 in the three months after the intervention. The incidence of CAUTI was reduced by 67% with a resulting decrease in CAUTI rate from 3.79 to 1.30 infections/100 catheter days although the results were not statically significant (<em>P</em>=0.48).</p> <p><strong>Conclusion: </strong>The present study was limited due to time constraints and lacked statistical power but did appear to indicate that the use of a nurse-driven urinary catheter protocol may decrease the rate of hospital acquired CAUTI and warrants further ongoing study.</p> <p><strong>Keywords</strong><strong>: </strong><em>Quality Improvement</em>, <em>Urinary Catheter Protocol, Catheter-Associated Urinary Tract Infection (CAUTI), Infection Prevention, Standard Infection Ratio (SIR), and Healthcare-Associated Infections (HAIs)<br /> <br /> </em></p>en
dc.formatText-based Documenten
dc.language.isoen_USen
dc.subjectCatheter associated urinary tract infectionsen
dc.subjectUrinary Catheter protocolen
dc.subjectHealthcare associated infectionsen
dc.subjecturinary tract infectionsen
dc.titleInstituting a Quality Improvement Program at a Community Medical Designed to Reduce Urinary Catheter Days and the Incidence of Catheter Associated Urinary Tract Infectionsen_US
dc.typeDNP Capstone Projecten
thesis.degree.grantorCapella Universityen
thesis.degree.levelDNPen
dc.description.noteThis work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.-
dc.primary-author.detailsMinnie L. Davis DNP, MSN, RN, ARNP, AGPCNP-BC, NP-C, CWCN; contact email: minniedavis@hotmail.comen
thesis.degree.year2016en
dc.type.categoryFull-texten
dc.evidence.levelOtheren
dc.research.approachTranslational Research/Evidence-based Practiceen
dc.subject.cinahlUrinary Tract Infections, Catheter-Related--Prevention and Controlen
dc.subject.cinahlUrinary Tract Infections, Catheter-Relateden
dc.subject.cinahlQuality Improvementen
dc.subject.cinahlUrinary Catheterizationen
dc.subject.cinahlCross Infectionen
dc.subject.cinahlNursing Protocols--Evaluationen
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