AACN Alert: Catheter Associated Urinary Tract Infections Melissa Bisel Kim Fulmerhouser Tessa Grewe David LaBelle

Objectives Introduce AACN Summarize AACN practice alert Briefly address levels of evidence Discuss quality and safety Conclusion

AACN Introduction Mission Vision Values Practice Alert Mission Patients and their families rely on nurses at the most vulnerable times of their lives. Acute and critical care nurses rely on AACN for expert knowledge and the influence to fulfill their promise to patients and their families. AACN drives excellence because nothing less is acceptable. Vision AACN is dedicated to creating a healthcare system driven by the needs of patients and families where acute and critical care nurses make their optimal contribution. Values As AACN works to promote its mission and vision, it is guided by values that are rooted in, and arise from, the Association’s history, traditions and culture. AACN, its members, volunteers and staff will honor the following: Ethical accountability and integrity in relationships, organizational decisions and stewardship of resources. Leadership to enable individuals to make their optimal contribution through lifelong learning, critical thinking and inquiry. Excellence and innovation at every level of the organization to advance the profession. Collaboration to ensure quality patient-and family-focused care.

CAUTI Practice Alert What is a CAUTI? Catheter Associated Urinary Tract Infection CAUTI can lead to such complications as cystitis, pyelonephritis, gram-negative bacteremia, prostatitis, epididymitis, and orchitis in males and, less commonly, endocarditis, vertebral osteomyelitis, septic arthritis, endophthalmitis, and meningitis in all patients. Complications associated with CAUTI cause discomfort to the patient, prolonged hospital stay, and increased cost and mortality2. Each year, more than 13,000 deaths are associated with UTIs.

CAUTI Practice Alert 80% of UTI’s are related to catheters Increased Hospital Stay Increased Morbidity & Mortality Extra Hospital Costs According to the AACN, up to 80% of all UTI’s are associated with catheters. Hearing that, it is a surprising statistic. CAUTI’s are very preventable and when the lack of care or attention to patient’s catheters, many other things fall alongside the complication. These complications include the four listed bullet points above. The AACN elaborates on noticing that when healthcare professionals lack care of a patient’s catheter, the hospital pays for it. Not only that, but the patient as well. At all costs, we are looking to provide brief, effective, and adequate care to all patients and their catheter collaboratively. 10% 90% (AACN Practice Alert, 2011)

Quality and Safety Establish proper protocol for urinary catheterization Design and implement training programs Review and assess patients daily for the continued need of catheterization Remove catheter as soon as it is discontinued

Quality and Safety Implement infection observation programs. Develop plans to address any improvements needed Use proper aseptic technique Document insertion date and removal date

References American Association of Critical-Care Nurses. (2014). Key statements, beliefs and philosophies behind the American Association o Critical-Care Nurses (AACN). http://www.aacn.org/wd/publishing/content/pressroom/aacnfactsheet.pcms?menu=publications# Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol. 2010;31:319-26.