LINDA HUDDLESTON, RN, MSN, CIC Director of Infection Prevention and Employee Health Tifani Kinard MHA, MBA, BSN, RN Director of Emergency Care Center

 Located in Northwest GA  304 bed facility  ICU with 16 beds  CCU with 8 beds  Medical residency program  Hospitalists  Emergency Care Center with 52 beds and 78,000 annual visits; Level II Trauma Center; JCAHO certified Stroke Center

 List the best practices to prevent CAUTI  Identify obstacles in decreasing both CAUTI and indwelling catheter utilization  Describe interventions that decrease CAUTI and indwelling catheter utilization

 The urinary tract is the most common site of Hospital Acquired Infections (HAIs)  Accounts for more than 30% of infections reported by acute care hospitals  More than 13,000 deaths each year (35/day)  Complications associated with CAUTI ◦ Discomfort ◦ Prolonged hospital stays ◦ Increased cost and mortality

 Develop and implement a policy with best practices  Ensure that trained personnel insert catheter  Use hand hygiene  Perform routine hygiene  Evaluate necessity of catheter every 24 hours  Use a closed drainage system  Use smallest gauge catheter if possible  Replace system if a break in asepsis occurs  Evaluate alternate methods  Avoid irrigation  Use barrier precautions for insertion  Do not change catheter routinely  Obtain urine samples aseptically SHEA Compendium of Strategies to Prevent HAIs, 2008

 73% of all Foley’s house wide were placed in the ECC  HABIT – always insert Foley in ECC  Lack of knowledge that an indwelling urinary catheter is harmful  Trained staff?  Convenience

◦ Champion  Partnership between Infection Prevention, Lean Six Sigma and the ECC ◦ Education  Mass re-education ◦ Accountability  Documentation in Clinical Record  Daily Omnicell Report  Follow up with Individual nurses

 18 months ago 73% of all Foley’s house wide were placed in the ECC……today 42% of Foley’s are placed in the ECC.  Cost savings of $

QUESTIONS?