Wallis C. CAUTI CNSs utilize a tiger team approach to decrease hospital-wide CAUTIS. Quality Improvement podium presentation at Nursing Passion: Re-Igniting the Art & Science, Advocate Aurora Health Nursing & Research Conference 2022; November 9, 2022; virtual.
Quality Improvement podium presentation at Nursing Passion: Re-Igniting the Art & Science, Advocate Aurora Health Nursing & Research Conference 2022; November 9, 2022; virtual.
Background: Catheter associated urinary tract infections (CAUTIs) are the fifth most reported healthcare acquired infection (NHSN, 2022). Evidence has shown higher CAUTI rates are associated with increased patient length of stay, patient discomfort, and mortality. A meta-analysis yielded additional cost of a CAUTI to be estimated at $13,793 (AHRQ 2017). Hospital acquired infections have been shown to decrease with implementation of consistent evidenced based practices.
Local problem: Prevention of CAUTIs was identified as a high priority initiative on a journey to zero harm, in a 938-bed quaternary urban acute care hospital. The hospital wide CAUTI rate was 2.89 and the standardized infection ratio (SIR) was 1.756 which were above targeted benchmarks.
Method: A CAUTI Tiger Team was assembled much like the military, bringing together a group of experts to investigate and resolve a critical issue. A baseline analysis of current processes and failure points was completed. Brainstorming was utilized to identify potential contributing factors and improvement strategies. A priority matrix was employed for action planning, timeline, and team member accountabilities. Two designated CAUTI prevention Clinical Nurse Specialists (CNSs) led monthly CAUTI champion meetings, nursing maintenance care competencies, and performed the drill down evaluation for every CAUTI event. A CAUTI toolkit was developed and disseminated hospital wide, along with a Culture Worksheet in collaboration with Tiger team members. Monthly CAUTI Prevention Safety Huddles were disseminated along with the percentage of patients with a urinary catheter at the hospital wide daily safety huddle.
Results: The CAUTI rate decreased by 78% and the CAUTI SIR dropped by 80%, from Q4 2020 to Q4 2021. This led to a cost avoidance of $358, 618.
Implications for practice: The Tiger team quality improvement approach was successful in reducing CAUTIs. This approach can be adopted by others for critical high priority healthcare initiatives to make improvements in patient outcomes.