A Collaborative Approach for the Reduction of CAUTI in a Long-Term Acute Care Facility

A review of the hospital's quality indicators revealed an unacceptable rate of catheter-associated urinary tract infection (CAUTI). The goal was to reduce the rate of CAUTI by 40 percent with the involvement of physicians, health care workers, patients and their families. The hospital piloted the interventions in one unit and then implemented them hospitalwide.

A number of interventions are used to decrease the rate of CAUTI: (1) on admission, patients with catheters are assessed for catheter necessity; (2) patients are assessed daily for catheter necessity; (3) bath cloths are used for catheter maintenance; (4) the hospital developed a nurse-driven, physician-approved urinary protocol; and (5) the hospital conducted a point prevalence study on insertion and maintenance of urinary catheters using the Centers for Disease Control and Prevention National Healthcare Safety Network benchmark of less than 2.0 CAUTIs per 1,000 urinary catheter days.

In 2012, the hospital had 56 CAUTIs, with a rate of 2.70; in 2013, there were 32 CAUTIs, with a rate of 1.70; and in 2014, there were 27 CAUTIs, with a rate of 1.15. In the first quarter of 2015, the hospital had four CAUTIs.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/