Engaging Residents and Families in CAUTI Prevention Content Webinar for Facility Team Leads and Core Team Members May 21, 2015 Sue Collier, RN, MSN, FABC Clinical Content Development Lead Health Research & Education Trust American Hospital Association

Learning Objectives Upon completion of this session, participants will be able to: define resident-centered care; review the benefits of engaging residents and families as partners in care; describe examples of how to engage residents and families in reducing CAUTIs; and identify tools and resources you can use to educate staff, residents and families.

What is Resident- and Family-Centered Care? A philosophy that keeps the person, the resident and their family at the center of every decision-making process A way to assure residents’ preferences are valued and respected Care that reflects the core concepts of person-centered care

What is Resident Engagement? An important component of resident-centered care An environment and culture that promotes residents, families, clinicians and all facility staff working together to improve quality and safety Recognition that residents and family are part of the team Actions that reflect the core concepts of resident-centered care

Consequences of Nursing Home Infections Leading cause of death and complications 150,000-300,000 admissions to hospitals from nursing homes each year Costliest of all adverse event-related hospitalization Prevention of these infections is critical in order to promote resident safety Every number is a resident! Montoya, Mody. Aging health. 2011 December ; 7(6): 889–899. doi:10.2217/AHE.11.80. Stone et al ICHE 2012. Smith PW et al ICHE 2008.

Benefits to Engaging Residents and Families Residents and families have the ultimate concern for infections Residents and families can help the staff by Asking questions Identifying problems and solutions Staff can be more efficient and feel more valued in a resident-centered environment Facilities have better outcomes when there is shared decision-making

What are some benefits of engaging residents and families in infection prevention? CHAT: Benefits

Achieving a Culture of Safety with C.A.U.T.I and T.E.A.M.S.

Using T.E.A.M.S. To Engage Residents/Families Include the residents/families Invite residents to planning meetings Encourage residents to speak up Share information concerning the prevention efforts Share performance—ask residents if they can see a change in practice Share stories Share prevention information in Resident Council meetings Include resident stories in safety meetings Include residents in new staff orientation and education Include CAUTI prevention information in admission packets Team Formation Excellent Communication Assess What’s Working Meet Monthly Sustain Efforts

Using C.A.U.T.I. To Engage Residents/Families Cather Removal Aseptic Insertion Using Regular Assessments Training for Catheter Care Incontinence Care Planning Tell residents/families you will assess need for catheter Share what you are doing to prevent UTIs Explain how you train staff to insert catheters properly Include resident council members in education Discuss alternatives to an indwelling urinary catheter Include family in discussions about catheter assessment Train residents/families in catheter care hygiene Explain the signs and symptoms; ask residents/family members to assist staff in assessments of UTI Ask residents and/or family members their preferences, needs and concerns Explain alternatives to catheters

What Should Residents Know About Urinary Catheters and CAUTIs? What is a urinary catheter? What is a CAUTI? How do I get a CAUTI? What are the symptoms? When should I NOT have a urinary catheter? What are the harms related to urinary catheter? If I already have a urinary catheter, what can I do? How can staff help me avoid needing a urinary catheter?

Describe what you do currently to engage residents and families in preventing CAUTI or any infections? CHAT: Engagement

Summary: Examples of Resident Engagement Include residents and their family in care decisions Involve residents and their family in safety rounds Share resident stories in meetings Ask residents or family members to share their stories Provide CAUTI prevention education to residents Share what you are doing to help prevent infections Ask residents and family to help educate staff Develop education materials with residents and family

CAUTI Tools and Resources for Residents and Families

LTC Safety Toolkit: Module 5 Resident and Family Engagement Methods and tools for working with residents and families as partners in their care to increase safety, improve satisfaction, and optimize resident outcomes Ways to use the toolkit include: Share videos with teams to spark engagement in staff safety assessments Provide templates and discussion guides to project leads Educate teams on T.E.A.M.S. and Just Culture Use videos and training modules to orient new staff Train teams in using teamwork and communication tools Engage senior leaders and project champions

What challenges have you had when engaging residents and family in CAUTI prevention? CHAT: Challenges

Educating All Staff in Resident And Family Engagement in a Culture of Safety Use slide set with facilitator’s notes Share recorded session for all staff Use Discussion Guide with key questions to spark conversations Provide copies of T.E.A.M.S. and C.A.U.T.I Infographics Provide Evaluation Form and Certificate of Completion

Your Role in Supporting Resident & Family Engagement in CAUTI Prevention (T.E.A.M.S.) Invite residents/families to serve on the safety teams; include resident stories in all safety improvement team meetings Encourage residents to speak up and communicate concerns Share information concerning the CAUTI prevention efforts Ask residents to their share stories Include safety information in Resident Council meetings Invite residents to participate in new staff orientation and education Include CAUTI prevention information in admission packets

Your Role in Supporting Resident & Family Engagement in CAUTI Prevention (C.A.U.T.I.) Monitor and report small changes in a resident's condition Ensure proper catheter insertion and maintenance Train residents/family in catheter care hygiene Explain the signs and symptoms of UTI Discuss alternatives to an indwelling urinary catheter Include family in catheter assessments

What will you do to engage residents and families in the CAUTI prevention program? CHAT: ACTION STEPS

Questions

References Agency for Healthcare Research and Quality. 2012. TeamSTEPPS® Long-term Care Version. Retrieved from http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/longtermcare/index.htm. Advancing Excellence in America’s Nursing Homes: Person-Centered Care. Retrieved from http://www.nhqualitycampaign.org/star_index.aspx?controls=personcenteredcareexploregoal. AHRQ CUSP Toolkit, Patient Family Engagement. Retrieved from http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/modules/patfamilyengagement/index.html. Frampton, et al. Long-term Care Improvement Guide. Retrieved from http://planetree.org/wp-content/uploads/2011/12/LTC-Improvement-Guide-For-Download.pdf. Association for Professional in infection Control and Epidemiology. Patient safety resources for consumers. Retrieved from http://www.apic.org/For-Consumers/Patient-safety-resources. Institute for Patient and Family Centered Care. Retrieved from http://www.ipfcc.org/advance/topics.html. Centers for Disease Control and Prevention. FAQs about Catheter-Associated Urinary Tract Infection. Retrieved from http://www.cdc.gov/HAI/ca_uti/uti.html.

Stay Updated with Useful Resources AHRQ Safety Program for Long-term Care: HAIs/CAUTI Project Website Login information Username: ltcsafety Password: ltcsafety TeamSTEPPS® for Long-term Care AHRQ Safety Program for Long-term Care: HAIs/CAUTI Project Website Login information Username: ltcsafety Password: ltcsafety TeamSTEPPS® for Long-term Care T.E.A.M.S. Infographic C.A.U.T.I Infographic