scholarly journals Revisiting CAUTI Prevention: A Multifaceted Approach using Lean Six Sigma

2020 ◽  
pp. 1-64
Author(s):  
Lisa Ann Behrend
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Six Sigma ◽  
Infection Prevention ◽  
Comprehensive Evaluation ◽  
Lean Six Sigma ◽  
Evidence Based ◽  
Infection Rates ◽  
Tract Infections

This project identified gaps in policy and processes to improve patient outcomes related to workflow in the catheter-associated urinary tract infection policy and process at a 400-bed hospital in southern California. Even with an evidence-based infection prevention bundle in place, the current process was not working, as demonstrated by high catheter-associated infection rates for the last two years. This project answers the question: Does the use of a comprehensive evaluation of the current policy and process using the Lean Six Sigma quality improvement model influence a reduction in infection rates in patients who have an internal urinary catheter over 15 weeks? Despite published consensus guidelines for the diagnosis, prevention, and treatment of catheter-associated urinary tract infections; a single, evidence-based approach to the reduction of urinary tract infection does not exist. Avoiding the placement of catheters and encouraging early removal are the most effective interventions to prevent infection. The outcomes of the project resulted in a decrease in infections and significant cost reduction for the organization related to patient days and fines. Implementation of teams, nurse-driven protocols, and the establishment of bi-annual staff education were successful interventions. Lean Six Sigma played a significant role in the recognition of practical strategies required to ensure the effective use of proven infection prevention and to decrease the burden of disease correlated with indwelling urinary catheterization.

Larger Numbers Needed

PEDIATRICS ◽  
1987 ◽  
Vol 80 (5) ◽  
pp. 764-764
Author(s):  
THOMAS E. WISWELL
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
First Year ◽  
Infection Rates ◽  
Symptomatic Urinary Tract Infection ◽  
Tract Infections ◽  
First Year Of Life

In Reply.— Dr Altschul presents data on urinary tract infections during infancy and reports infection rates substantially lower than those we have previously reported.1,2 He then makes several conclusions based on these differences. His data indicate that the maximum infection rates would be 0.11% among girls and 0.02% and 0.12% among circumcised and uncircumcised boys, respectively. In contrast, from a population of 422,328 infants, we found the overall incidence of symptomatic urinary tract infection during the first year of life to be 0.57% in girls, 0.11% in circumcised boys, and 1.12% in uncircumcised boys.

Reducing Catheter-Associated Urinary Tract Infection in the Critical Care Unit

2010 ◽  
Vol 21 (3) ◽  
pp. 247-257 ◽  
Author(s):  
Mikel Gray
Keyword(s):  
Urinary Tract Infection ◽  
Critical Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Prevention Program ◽  
Critical Care Unit ◽  
Evidence Based ◽  
Indwelling Catheters ◽  
Tract Infections ◽  
Hospital Acquired

Changes in reimbursement policies have focused attention on the use of indwelling catheters in the critical care unit as well as their role in hospital-acquired urinary tract infections. Implementation of an evidence-based prevention program can significantly reduce both the prevalence of indwelling catheterization and the incidence of hospital-acquired catheter-associated urinary tract infection. This article describes the epidemiology and pathophysiology of catheter-associated urinary tract infection, and outlines essential elements of an evidence-based prevention program for the critical care unit.

scholarly journals Housestaff Knowledge Related to Urinary Catheter Use and Catheter-Associated Urinary Tract Infections

2015 ◽  
Vol 36 (11) ◽  
pp. 1355-1357 ◽  
Author(s):  
Molly L. Paras ◽  
Erica S. Shenoy ◽  
Heather E. Hsu ◽  
Rochelle P. Walensky ◽  
David C. Hooper
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Teaching Hospital ◽  
Infection Prevention ◽  
Urinary Catheter ◽  
Clinical Scenarios ◽  
Prevention Guidelines ◽  
Tract Infections

Despite published catheter-associated urinary tract infection prevention guidelines, inappropriate catheter use is common. We surveyed housestaff about their knowledge of catheter-associated urinary tract infections at a teaching hospital and found most are aware of prevention guidelines; however, their application to clinical scenarios and catheter practices fall short of national goals.Infect. Control Hosp. Epidemiol. 2015;36(11):1355–1357

Applying Mindful Evidence-Based Practice at the Bedside Using Catheter-Associated Urinary Tract Infection as a Model

2013 ◽  
Vol 34 (10) ◽  
pp. 1099-1101 ◽  
Author(s):  
Hiroko Kiyoshi-Teo ◽  
Sarah L. Krein ◽  
Sanjay Saint
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Infection Prevention ◽  
Evidence Based Practice ◽  
Catheter Removal ◽  
Evidence Based ◽  
Practice Model

We introduce a mindful evidence-based practice model to operationalize mindfulness to improve bedside infection prevention practices. Using catheter-associated urinary tract infection prevention as an example, we illustrate how clinicians can be more mindful about appropriate catheter indications and timely catheter removal.

scholarly journals Reducing Catheter-Associated Urinary Tract Infection Project

2020 ◽  
Author(s):  
◽  
Beatriz Agado
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
The United States ◽  
Evidence Based ◽  
Rehabilitation Center ◽  
Post Intervention ◽  
Practice Problem ◽  
Tract Infections

Practice Problem: Catheter-associated urinary tract infections (CAUTIs) are prevalent and responsible for an estimated 13,000 deaths annually in the United States. Reported cases of CAUTIs remain disproportionately high at a rehabilitation center located in South Texas. PICOT: This evidence-based project answered the following question: In rehabilitation patients, what is the effect of a nurse-driven protocol (NDP) CAUTI bundle on the number of indwelling urinary catheter-related infections, compared to the current practice, over a 12-week time period? Evidence: Twenty high-quality studies that met the inclusion and exclusion criteria recommended using an NDP CAUTI bundle, education, and champions to round the unit to decrease the number of catheter-associated urinary tract infections. Intervention: The evidence-based intervention utilized the implementation of an NDP CAUTI bundle. The intervention bundle included catheter indication, hand hygiene, an insertion technique, maintenance, ongoing assessment to evaluate catheter need, and documentation. Outcome: The evaluation of the outcome measures demonstrated that the CAUTI rate decreased from six incidences in 2019 to two from January to May 2020. There were zero incidences during the project implementation from June to August 2020, and the number of catheter days decreased from 59% at baseline to 41% post-intervention. Conclusion: The implementation of a nurse-driven protocol CAUTI bundle, education, and champions in the unit were successful interventions that decreased the catheter-associated urinary tract infection rates in the rehabilitation center.

Abbreviated Surveillance of Nosocomial Urinary Tract Infections: A New Approach

1985 ◽  
Vol 6 (1) ◽  
pp. 11-13 ◽  
Author(s):  
Esther E. Costel ◽  
Sue Mitchell ◽  
Allen B. Kaiser
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Passive Surveillance ◽  
Infection Rates ◽  
New Approach ◽  
Time Commitment ◽  
Nosocomial Urinary Tract Infection ◽  
Tract Infections

AbstractAn abbreviated method for the surveillance of nosocomial urinary tract infection is described. Combining desirable features of both active and passive surveillance, this new method involves concurrent review of microbiology reports. Compared to traditional active surveillance methods which require review of individual patient charts, the abbreviated method requires only one-fifth the time commitment while maintaining a 98% sensitivity. Although some degree of overestimation is inherent in this method, the primary goals of surveillance—monitoring infection rates and identifying clusters of infection—should be preserved.

Risk Factors in Diabetes and Pregnant Women with Urinary Tract Infections Compared to Younger Aged Female.

2018 ◽  
Vol 1 (3) ◽  
pp. 26-38
Author(s):  
Abdulghani Mohamed Alsamarai ◽  
Shler Ali Khorshed
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnant Women ◽  
Female Student ◽  
Mean Value ◽  
Infected Female ◽  
Significant Difference ◽  
Tract Infections

Background: Urinary tract infection is common with health impact in women and characterised by failure to treatment and recurrent episodes. Aim: This study was conducted to determine the risk factors for the development of urinary tract infection in diabetic and pregnant women in comparison to student female. Materials and methods: A prospective cross-sectional study conducted during the period from 1st of June 2015 to the end of January 2016. The population included in the study are 563 women, of them 425 were outpatients, and 138 were inpatients. Their age range between 18 and 80 years, with a mean age of 33.59±15.29 years. Urine samples collected and cultured on blood agar and MacConkey agar by spread plate technique. Bacterial colonies with different morphology were selected, purified and identified according to their biochemical characteristics using conventional standard methods. Results: In diabetic women, there were no significant difference in mean age and BMI values between culture positive and culture negative groups. However, pus cell mean scale was significantly higher [P=0.000] in women with urinary tract infection [1.76±1.25] than in those with negative culture [0.69±1.00]. In pregnant women, BMI mean value was significantly [P=0.013] lower in pregnant women with UTI [26.14] as compared to those without infection [26.99]. Pus cell scale mean value was significantly [P=0.000] higher in pregnant women with UTI [1.55] than women with negative UTI [0.85]. While there was no significant difference in mean age between UTI positive and negative pregnant women. In female student, there was a significant difference between UTI infected and non-infected in mean age [P=0.041] and pus cell scale [P=0.000]. However, BMI was not significantly different between infected and non-infected female student. Other risk factors association are variables in the 3 groups when analysed using X2, while AUC and OR show different trends of association between risk factors and UTI. Conclusion: BMI, pus cell scale, child number, delivery method, operation history and hospital setting were significantly associated with culture positivity in the 3 studied groups as determined by AUC. While OR confirmed association with pus sale scale in the 3 groups.

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