ABHB Interventions aimed at reducing CAUTI Catheter Associated
ABHB Interventions aimed at reducing - CAUTI (Catheter Associated Urinary Tract Infection).
Background n Urinary Tract Infections (UTI) are one of the most common Health Care Associated Infections n Urethral catheters alter the body’s natural defence mechanism and provides constant portal. n Chance of CAUTI increases with the longer the catheter is in situ (approx. 5% per day) n CAUTI contributes to increased morbidity, mortality, prolonged hospital stays, financial costs, plus pain and distress for patients.
Current Situation n Documentation/ Evidence surrounding the standard of catheter care we provide is poor or missing n Infection rates are unclear n An All Wales steering group are reviewing methods of sharing best practice and providing a consistent standard. (95%)
Potential Care bundles linked to urethral catheter care. n A package of individual actions or behaviours that when linked together, for a specific clinical practice, can increase effectiveness and improve outcome n Insertion bundles n Maintenance bundle n Specimen collection bundle.
Considerations & Choices Insertion v’s maintenance Data collection v’s paper collection Processes and outcome measurements
Standard for maintenance Care Bundle to reduce CAUTI Element 1 Catheter Stand: A catheter bag stand must always be used. The bag should be placed lower than the bladder but have no contact with the floor. Element 2 Personal Protective Equipment When empting catheter bags, PPE (gloves and aprons) should be worn. A visor should be used if chance of splashing. Remember: Hand hygiene is required before and after glove use. Element 3 Clean Receptacle A clean receptacle must be used every time a catheter bag is emptied. . Element 4 Empty at least daily/ or as required Catheter bags should be emptied at least daily or as required -dependant on patients condition or monitoring processes. Each break of the circuit presents Cross infection opportunities. Record emptied measured output in daily TCAB/ or equivalent Element 5 Catheter Toilet /wash Daily cleaning of meatus and catheter with soap and water reduces potential for infections to pass up outer coating of the catheter. Please document daily in TCAB/ or equivalent when catheter toilet is preformed by patient or staff Element 6 Continued need for catheter Please regularly document in TCAB, the medical/ nursing assessment stating why the catheter is still needed. Include assessment and review date.
Monitoring Tool n One tool to incorporate all components of bundle n Could indicate the repetition and sustainability of compliance of care bundle throughout a ward. n Simple to use- capturing compliance, with a scoring capability for individual elements and the bundle as a whole. n Includes assessment of knowledge n Familiar audit format ( hand hygiene)
Maintenance – monitoring tool. .
How did they do?
Prevalence Survey Monthly: All patients with urethral catheters insitu for more than 48 hours will be reviewed via: n n n Notes Antibiotic therapy Observation charts Correlation with CAUTI specifications and definitions will be made and outcome rates established
Outcome measurements. n in infection rates n in number of catheters cared for n in number days of catheter.
Any Questions or Suggestions
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