1. Applying the NHSN CAUTI Criteria to Case Studies
National Content Series for Facility Team Leads and Core Team Members
July 16, 2015
Welcome to today’s content webinar for all LTC facility staff on how to apply the NHSN CAUTI criteria to case studies. This webinar is part of the Agency for Healthcare Research and Quality’s (or AHRQ’s) Safety Program for Long-term Care that addresses healthcare-associated infections (or HAIs) and catheter associated urinary tract infections (or CAUTI).
My name is Steve Schweon. I am a nurse and an infection preventionist, working as a member of this program’s national project team, with support from the Association for Professionals in Infection Control and Epidemiology, or APIC.
Steven J. Schweon RN, MPH, MSN, CIC, HEM, FSHEA
APIC
Infection Preventionist

2. Learning Objectives
Upon completion of this webinar, facility team leads and core team members will be able to:
apply CAUTI signs and symptoms as defined by the NHSN criteria in long-term care to case studies;
use the train-the-trainer materials to cascade content to facility front-line staff;
identify how every team member can help reduce health care-associated infections and provide safe care; and
explain the importance of every team member's role in connecting CAUTI identification to their facility's overall safety plan for residents and staff.
Upon completion of this webinar, facility team leads and core team members will be able to:
apply CAUTI signs and symptoms as defined by the NHSN criteria in long-term care to case studies;
use the train-the-trainer materials to cascade content to facility front-line staff;
identify how every team member can help reduce health care-associated infections and provide safe care; and
explain the importance of every team member's role in connecting CAUTI identification to their facility's overall safety plan for residents and staff.

3. “The Catheter’s Lament”
I am a urinary catheter Dark places I must go My job is clear I have no fear I need to ease the flow You are the one I am inside It enters not your head That if I’m left in (a moral sin) You could just end up dead At times, I am useful aide But my use you should not flout On every day Someone should say It’s time to take me out! Dr. Martin Kiernan
I always like to start my educational offerings and committees with a little bit of humor:
The Catheter’s Lament:
I am a urinary catheter
Dark places I must go
My job is clear
I have no fear
I need to ease the flow
You are the one I am inside
It enters not your head
That if I’m left in
(a moral sin)
You could just end up dead
At times, I am useful aide
But my use you should not flout
On every day
Someone should say
It’s time to take me out!
Dr. Martin Kiernan

4. Don’t Be Shy!
One goal is to make this presentation as interesting and as engaging as possible. There will be opportunities to share your knowledge and ask questions throughout.

5. Background
Urinary tract infections (UTIs) are the most frequently reported infections in nursing homes and drive antibiotic use.1
Monitoring and performing surveillance of both catheter-associated and non- catheter associated UTIs helps to identify potential trends and helps prevent infection and decrease antibiotic use.
Tracking and preventing infections is a resident quality of life and safety issue.
We need to understand why we perform surveillance in the first place? It can be very time consuming and we need to be able to leverage our findings:
Urinary Tract Infections (UTIs) are the most frequently reported infections in nursing homes and drive antibiotic use.
Monitoring and performing surveillance of both catheter-associated and non-catheter associated infections helps to identify potential trends and provide information with preventing infection and decreasing antibiotic use.
Tracking and preventing infections is a resident quality of life and safety issue.
1NHSN LTC definitions

6. Educate All Staff to Identify CAUTI Signs and Symptoms
Use slide set with facilitator’s notes
Share recorded session for all staff who interact with residents
Use case study to assess knowledge gained and encourage team discussion
Provide copies of tools to guide CAUTI identification
Provide Evaluation Form and Certificate of Completion
Before we get started, let’s talk about ways to share the information we discuss during today’s webinar. The team leader can either customize the presentation to focus specifically on elements that effect their facility or play the short 15-minute video geared for the front-line staff. This format allows the trainer to utilize different training techniques as needed by their facility staff. The video option is particularly useful for educating staff who are unable to attend viewings at designated times.
During the education session, whether using the video recording or presenting the information live:
Encourage staff to ask questions and share any concerns throughout the session.
Pause the video as needed to address questions.
Encourage staff to share stories of challenges or barriers to meeting the expectations.
At the end of the video ask staff to answer the case study and review each question and correct answers with the entire group. Provide additional resources or follow-up as needed based on participant responses.
Thank the staff for attending, have staff complete the evaluation and reinforce the importance of their role in eliminating CAUTI and other HAIs.

7. Case 1
While traveling through the airport, a man was ambulating with his indwelling urinary catheter… and it raises dignity and infection education issues.
There is a person and story behind every urinary catheter.
Which leads me to the story of a man I noticed while traveling through the Allentown airport. As you can see he was walking with his urinary catheter tubing hanging out and his collection bag clipped to his pants.
[CLICK]
This raises dignity and infection education issues.

8. Case 2
Summit Wilkins is 52 year-old patient that is post-surgery for intervertebral disc disease (IVDD)
Postoperatively, the indwelling urinary catheter must remain in place
Per CMS regulations, the patient is forbidden to be admitted to a LTC facility
This is another interesting urinary catheter presentation:
Summit Wilkins is 52 y.o. patient, status post-surgery for intervertebral disc disease (IVDD)
Postoperatively, the urinary catheter must remain in place
Per CMS regulations, the patient is forbidden to be admitted to a LTC facility

9. Case 2
Summit Wilkins is 52 y.o. patient, status post surgery for intervertebral disc disease (IVDD)
Postoperatively, the urinary catheter must remain in place
Per CMS regulations, the patient is forbidden to be admitted to a LTC facility
The patient is a terrier mix and belongs to Amanda Wilkins
The patient is a terrier mix and belongs to HRET team member Amanda Wilkins
Amanda, how is your dog doing?
Perhaps if we have time at the end, you can share what it was like to care for a dog with a urinary catheter?

10. Importance of Storytelling
Telling interesting stories will quickly grab your audience’s attention
Storytelling connects the hands, head and heart so that attendees walk away knowing and connecting with why they are participating in the meeting/training/event
You can also tell a story when you present data
Clearly, telling interesting stories will quickly grab your audience’s attention. Did you find yourself listening?
Storytelling connects the hands, head and heart so that attendees walk away knowing and connecting with why they are participating in the meeting/training/event.
You can also tell a story when you present data…

11. Why Do We Perform Surveillance?
Essential component of the infection prevention program
Protects the resident & employee’s health
Part of the facilities performance improvement plan; provides feedback for your infection prevention program
Information may be useful for residents and families
CMS regulatory requirements
Why Do We Perform Surveillance?
Essential component of the infection prevention program
Protects the resident & employee’s health
Part of the facilities performance improvement plan; provides feedback for your infection prevention program
Information may be useful for residents and families
CMS regulatory requirements

12. Four Questions to Identify a CAUTI
Does the resident have an indwelling urinary catheter connected to a drainage device?
Does the resident have one or more CAUTI symptoms?
Is there no other explanation for this resident’s symptoms?
Does the resident have a urine culture that fits the criteria?
At this point, let’s review what you already learned in onboarding 2 about identifying CAUTI.
If you suspect that a resident has a CAUTI, ask yourself:
Does the resident have an indwelling urinary catheter connected to a drainage device?
Does the resident have one or more CAUTI symptoms?
Is there no other explanation for this resident’s symptoms?
Does the resident have a urine culture that fits the CAUTI criteria?
[CLICK]
If you answered “YES” to all of these questions…
then the resident does indeed have a CAUTI.
YES YES YES YES
then the resident has a CAUTI!

13. CAUTI Criteria—NHSN Definitions Pocket Cards
The LTC Program has a host of materials and training aids posted to the ltcsafety.org website to assist you with hardwiring your facility to prevent infection:
For example
The NHSN Definitions Pocket Cards are a resource to identify CAUTIs based upon NHSN criteria.
Nursing/assistive staff can use the pocket cards while rounding to evaluate residents for possible signs and/symptoms of CAUTI.
Physicians/clinicians may use it to evaluate residents with signs and/or symptoms of CAUTI before prescribing antibiotic treatment.
Additionally, these tools are great for printing, laminating and distributing to all direct care providers.
Now, before we can begin to apply the NHSN CAUTI criteria to case studies, we have to understand the signs and symptoms…
[CLICK]
…that are identified here.

14. What are the Signs and Symptoms of CAUTI?
ONE or MORE of the following:
CAUTI Sign or Symptom
Fever
Rigors (chills and sweats)
New confusion or functional decline
(with NO alternative diagnosis AND leukocytosis)
New suprapubic pain or costovertebral angle pain or tenderness
New onset hypotension
(with no alternate site of infection)
Acute pain, swelling or tenderness of the testes, epididymis or prostate
Purulent (pus) discharge from around the catheter
Recall that the second question asks “Does the resident have one or more CAUTI symptoms?” The following are CDC acceptable signs and symptoms associated with a CAUTI:
Fever
Rigors
New onset confusion or functional decline
New onset of suprapubic pain or costovertebral angle pain or tenderness
New onset hypotension
Acute pain, swelling or tenderness of the testes, epididymis or prostate gland
Purulent discharge or pus from around the catheter
If a resident with an indwelling catheter (or one removed in the last 2 days) has just one of these symptoms and a positive urine culture meeting CDC criteria, it will then count as a CAUTI
All levels of staff involved in direct resident care should be familiar with these symptoms and understand how to observe, report and document them. If you or staff members need to refresh yourself on the details of how to identify these symptoms, review the onboarding 2 video for all staff.
See Onboarding 2: CAUTI Definitions and Reporting video for all LTC staff for further details

15. Urine odor or smell, by itself, does not predict a UTI
Urine odor may result from:
Dehydration
Medications (e.g., antibiotics)
Food (e.g., asparagus, onions, garlic)
Total Parenteral Nutrition (TPN)
Alcohol, coffee
Urinary tract infection
Urine odor or smell, by itself, does not predict a UTI
You may have noticed that odor, or foul smelling urine, is NOT a CAUTI sign or symptom. This is because urine odor may result from:
Dehydration
Medications e.g. antibiotics
Foods e.g. asparagus, onions, garlic
Total Parenteral Nutrition (TPN)
Alcohol, coffee
Urinary tract infection
Remind all staff that urine odor or smell, by itself, does not predict a UTI.
Instead, all staff should monitor and assess the resident’s condition.

16. Anybody Feeling Sleepy?!
I just want to briefly check in and hope folks are finding this presentation interesting and informative; please feel free to chat and let us know!

17. Surveillance Case Review
The LTC Program Facility Team Leader and core team are very important to understanding whether to document a UTI as a CAUTI or not. So we’ll first review a few cases to prepare you. Then, we’ll go into more detail about how to engage all staff in identifying, communicating and documenting signs and symptoms of a CAUTI
So, for the remainder of this program we’ll provide the team leader and core team with specific examples of how to engage and support the front-line staff.
Surveillance Case Review

18. Scenario 1: Date of Event
POLL
Scenario 1: Date of Event
The date of event is when the first clinical evidence (signs, symptoms) of the UTI appeared, or the date the specimen was collected, to make the diagnosis, whichever comes first.
Calendar Day
Urinary catheter
Resident signs and symptoms
Date of event
July 1
Catheter in place
Complaining of suprapubic pain, 102°F, UA, culture ordered
Symptoms began July 1
July 2
Hypotensive, antibiotics started
July 3
E. coli in urine, diagnosed with CAUTI
Calendar Day
Urinary catheter
Resident signs and symptoms
Date of event
July 1
Catheter in place
Complaining of suprapubic pain, 102°F, UA, culture ordered
July 2
Hypotensive, antibiotics started
July 3
E. coli in urine, diagnosed with CAUTI
Remember from onboarding 2 that the date of event is when the first clinical evidence (signs, symptoms) of the UTI appeared, or the date the specimen was collected, to make the diagnosis, whichever comes first.
In this example, on July 1, the resident with a urinary catheter is complaining of suprapubic pain, is febrile at 102 °F . A UA and culture are ordered.
On July 2, the resident worsens with hypotension and antibiotics are stared.
On July 3, a E. coli CAUTI is diagnosed.
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In this example, what is the date of event?
The signs and symptoms began on July 1; so, July 1 is the date of event.
What is the date of event?

19. Present on Admission (POA) vs. Healthcare-associated Infection (HAI)
POLL
Present on Admission (POA) vs. Healthcare-associated Infection (HAI)
UTI events presenting > 2 calendar days after admission, where admission is Day 1, is considered LTC facility-associated.
Calendar Day
Urinary catheter
Resident signs and symptoms
POA or HAI
1 (Admission)
Catheter in place
None 2
101°F, no other alternative infection sources, cultures obtained
POA 3
Positive culture, hypotensive, rigors
Calendar Day
Urinary catheter
Resident signs and symptoms
POA or HAI
1 (Admission)
Catheter in place
None 2
101°F, no other alternative infection sources, cultures obtained 3
Positive culture, hypotensive, rigors
As defined by the CDC, UTI events presenting > 2 calendar days after admission, where admission is day #1, is considered LTC facility-associated.
In this example, on calendar day 1, the resident is admitted with a catheter.
On day 2, the resident is febrile and cultures are obtained
On day 3, the culture comes back and the resident continues to decompensate
[CLICK]
In this example, is the CAUTI POA or LTC facility-associated?
In this example, the signs and symptoms began on calendar day #2. Therefore the infection is POA.
If the resident transferred from another health care facility, it would be prudent to inform them of the CAUTI.
Is the CAUTI POA or HAI?

20. POLL
UTI vs. CAUTI
The resident must have a urinary indwelling catheter in place, for a minimum of 2 calendar days, before infection onset, (Day 1 = Day of insertion), for the infection to be catheter associated (i.e., CAUTI starts on Day 3)
Calendar Day
Urinary catheter in place
Resident signs and symptoms
UTI or CAUTI 1
Catheter inserted
None 2
Catheter in place
101°F, no other alternative infection source, cultures obtained
Symptoms first start; UTI 3
Hypotensive, CVA pain
Calendar Day
Urinary catheter in place
Resident signs and symptoms
UTI or CAUTI 1
Catheter inserted
None 2
Catheter in place
101°F, no other alternative infection source, cultures obtained 3
Hypotensive, CVA pain
The resident must have a urinary indwelling catheter in place, for a minimum of 2 calendar days, before infection onset, (Day #1=day of insertion), for the infection to be catheter associated. (CAUTI starts Day #3)
Read the scenario in the table
CLICK]
In this example, is this a UTI or a CAUTI?
[CLICK]
Symptoms first start before the catheter has been in place for two days, making this a UTI, not a CAUTI.
Is this a UTI or a CAUTI?

21. POLL
UTI vs. CAUTI
A CAUTI occurs when a resident develops signs or symptoms if the urinary catheter is removed within the 2 calendar days prior to the date of event. (Catheter removal = Day 1)
Day
Urinary catheter in place
Resident signs and symptoms
UTI or CAUTI 1
Catheter discontinued
None 2
Catheter out
100.5°F with no other alternative infection source, cultures obtained
CAUTI; symptoms began within 2 calendar days 3
Hypotensive, CVA pain,
Day
Urinary catheter in place
Resident signs and symptoms
UTI or CAUTI 1
Catheter discontinued
None 2
Catheter out
100.5°F with no other alternative infection source, cultures obtained 3
Hypotensive, CVA pain,
A CAUTI occurs when a resident develops signs or symptoms if the urinary catheter is removed within the 2 calendar days prior to the date of event. (Catheter removal = day #1)
Read the clinical scenario in the table
CLICK]
In this example, is this a UTI or a CAUTI?
[CLICK]
This is a CAUTI; symptoms began within 2 calendar days
Is this a UTI or a CAUTI?

22. Surveillance Tip Be diligent!
Sometimes, working with the surveillance definitions can result in:
Have the surveillance definitions in front of you while performing the chart review
Credible resources
Contact your organizational lead
Reach out to your faculty coach for assistance
Contact the CDC at
Be diligent!
It’s very challenging with trying to memorize all the nuances of the surveillance definitions. Instead, have the definitions right in front of you, where you can eyeball them, when performing the chart review. In addition, try to ascertain why the resident had the urinary catheter in the first place.
Sometimes, while working up the infection, the definitions or the case presentation can be very confusing, and can lead to frustration.
There are 3 credible resources that you can lean upon to alleviate your frustration:
Contact your organizational lead
Contact your coach
Contact the CDC at
Make sure to have all your surveillance tools handy and readily accessible. A workbook of surveillance resources is included in the training materials found in the Core Team Resources pod on your screen.

23. Knowledge & Skills Transfer
The LTC Program Facility Team Leader and core team are very important to the successful implementation of the program. In general, the facility team leader is expected to promote the project goals, educate staff and encourage team members to commit to interventions that aim to reduce CAUTI and improve the safety culture.
So, for the remainder of this program we’ll provide the team leader and core team with specific examples of how to engage and support the front-line staff.
Knowledge & Skills Transfer

24. Train-the-Trainer Materials
Infection prevention should be part of your facility’s resident safety plan
All team members should continually assess the residents for possible CAUTI, other infections and changes in condition
All team members need to promptly report any changes in condition to the appropriate clinical team members
Training materials offer additional opportunities to review case scenarios to better equip the team with assessing the residents for possible CAUTI, other infections and changes in condition
Infection prevention should be part of your facility’s resident safety plan
All team members should continually assess the residents for possible CAUTI, other infections and changes in condition
All team members need to promptly report any changes in condition to the appropriate clinical team members
Training materials offer additional opportunities to review case scenarios to better equip the team with assessing the residents for possible CAUTI, other infections and changes in condition

25. Preventing CAUTI is a Team Sport
POLL
Preventing CAUTI is a Team Sport
All health care personnel, regardless of their discipline, are important with ongoing resident awareness and assessing for CAUTI and other changes in condition Make this part of your facility safety plan!
Role
Scene
Observation
CNA
Morning care
Purulent discharge around the catheter PT
Physical therapy session
New onset of confusion
Unit secretary
Speaking with resident
Pain RN
Assessment
Flushed appearance
Dietary Staff
Dining room
Shaking/chills
All health care personnel, regardless of their discipline, are important with ongoing resident awareness and assessing for CAUTI and other changes in condition.
Make this part of your facility safety plan!
[CLICK]…Table appears
In your facility, do all team members, who clearly play a role with resident safety, feel comfortable with relaying this information to the appropriate staff?
Do all team members, who clearly play a role with resident safety, feel comfortable with relaying this information to the appropriate staff?

26. CAUTI Case Scenario Example –Part 1 Mary Christmas
Mary is a 75 year old female w/ degenerative arthritis in her legs; Mary is status post-hip replacement surgery and weighs 210 pounds
Mary was admitted on Friday at 5 p.m. with an indwelling urinary catheter and was afebrile; the written hospital transfer report does not include an indication for a urinary catheter and Mary doesn’t know why the catheter is still in
The admitting nurse calls the hospital, but is unable to locate a nurse who is familiar with Mary; the physician will not see Mary until Monday
The following several slides review the case study that accompanies the All Staff training materials.

27. CAUTI Case Scenario Example –Part 2 Mary Christmas
Throughout the weekend, Mary’s urinary catheter stays in and the facility experiences staffing challenges due to call-outs; during morning care a nursing assistant states that she is grateful Mary has a catheter
During the Sunday morning assessment, another nursing assistant notes that Mary’s oral temperature is 100.7°F. The dietary staff notice that Mary has chills while she is eating her lunch; the nurse contacts the attending physician and notes there are no other signs of infection. Monday morning t he physician performs a complete assessment on Mary and can find no other explanation for her fever and rigors
The attending physician orders a urinalysis, urine culture and antibiotics.
Resident case studies are an excellent way to highlight CAUTI and infection prevention clinical and cultural education. This example provides clinical information, staff observations and behaviors, as well as real examples of the situations staff face everyday in LTC facilities.
A case study can be used by facility team leaders to educate staff on:
signs and symptoms to look for;
changes in a resident’s care or behavior that may indicate any potential healthcare-associated infections, such as CAUTI;
facility policies and procedures relative to infection prevention;
how to effectively communicate information or talk about concerns with other team members; and
how important it is to work as a team to ensure resident safety!
While we have provided you with this case study example, you may find it especially effective to create a case study using real examples from your facility. You can highlight staff who successfully identified significant changes in a resident’s signs and symptoms or how different members played an important part in a particular resident’s safety.

28. CAUTI Case Review Sample Questions –Part 1
What parts of Mary’s story sound familiar?
Name the staff who have a role in observing and/or reporting Mary’s condition. What can each of these staff do to help prevent an infection?
Is the catheter indicated? Does Mary meet the criteria for a CAUTI?
Once your decide which case study you want to use to demonstrate the clinical and cultural elements of CAUTI prevention, you can use open-ended questions to facilitate a discussion with staff. The next two slides highlight some questions you may consider asking.
The first question “What parts of Mary’s story sound familiar”, can be used to connect staff to their own experiences when caring for or supporting resident care.
By calling out the titles of staff who have a role in observing and/or reporting Mary’s condition, you help individuals recognized their personal responsibility and opportunity to be an active team member in preventing CAUTIs. Asking “What can each of these staff do to help prevent an infection? “ provides staff the chance to call out specific behaviors and provides leaders the chance to reinforce expectations.
Asking questions such as “Is the catheter indicated? “ or “Does Mary meet the criteria for a CAUTI?” provides the chance to educate team members on the criteria used to determine if a resident has a CAUTI and begin to gain confidence in questioning the presence of catheters.

29. CAUTI Case Review Sample Questions –Part 2
Does your facility have a policy about urinary catheter care and maintenance? If you have a question about your facility’s catheter policies, where would you go to find the policy and who could you ask to get more information?
How do you know if catheter care is performed according to policy? Where is catheter care documented? What kind of information does your facility document (device securement, closed system maintenance, collection bag maintained below the bladder level, etc.)?
How do staff share resident safety concerns with other staff or leaders? Do staff feel comfortable speaking up when they observe a break in protocol?
What LTC Program educational materials and tools are available for you to use at your facility to help prevent and document CAUTIs?
What additional information about Mrs. Christmas is needed to determine if she has a CAUTI?
Does your facility have a policy about urinary catheter care and maintenance? If you have a question about your facility’s catheter policies, where would you go to find the policy and who could you ask to get more information?
What are your facilities policies. As the team lead it is important that you know and understand these policies so you can be a resource for staff.
How do you know if catheter care is performed according to policy? Where is catheter care documented? What kind of information does your facility document (device securement, closed system maintenance, collection bag maintained below the bladder level, etc.)?
Are there policies and procedures you could help put in place to better help staff be able to track this information?
How do staff share resident safety concerns with other staff or leaders? Do staff feel comfortable speaking up when they observe a break in protocol?
Try to think about this question from the staff’s perspective. What can you do as the Team Leader to encourage staff to speak-up and share their concerns?
What LTC Program educational materials and tools are available for you to use at your facility to help prevent and document CAUTIs?
What additional information about Mrs. Christmas is needed to determine if she has a CAUTI?
The slide 31 provides specific examples of education guides and tools available to you as part of this program.

30. Your Role in Engaging Staff in CAUTI Prevention
The video and learning activity for front-line staff focuses on recognizing and communicating CAUTI
Key messages from that training resource include:
All personnel, regardless of their specialty, are important to assessing residents’ condition
CAUTIs can be prevented by following policy and adhering to best practices.
Review the video and the accompanying case scenarios before facilitating discussion with your front-line staff and providers
Share information with all staff/teammates
Use the CAUTI definition tools to build, encourage and support staff to correctly identify CAUTI signs and symptoms
Recognize staff who accurately observe, report, document and monitor signs and symptoms
In order to empower frontline staff to share safety concerns with other team members or leaders and to speak up when resident safety protocol is in question, staff must have the skills, knowledge, and confidence to be actively engaged in the work.
We have provided a recorded video and learning activity for all facility staff that focuses on recognizing and communicating CAUTI. Key messages from that training resource include:
All personnel, regardless of their specialty, are all important with assessing the residents
CAUTIs can be prevented by following policy and adhering to best practices.
Please review the video and the accompanying case scenarios before facilitating discussion with your front-line staff and providers.
Share the information with all staff in the facility and use the standardized definitions tools so that staff can be confident they can accurately identify CAUTI. Discuss with all staff and teammates how they can use the education to provide better, safer care to residents.
Some staff will provide the formal education while others may be involved in reinforcing positive behaviors related to communicating and documenting signs and symptoms. Every team member needs to feel they have a very important role in providing a safe, infection-free environment.
[CLICK]
By empowering frontline staff to observe, report and document changes in a resident’s condition, staff will feel comfortable bringing up resident safety concerns to other team members or team leaders. They will also be more likely to speak up when a potential break in resident safety protocol may occur or actually occurs.
Empower Frontline Staff to:
Feel comfortable bringing up resident safety concerns to other team members or team leaders
Speak up when a potential break in resident safety protocol may occur or actually occurs

31. Stay Updated with Useful Resources
NHSN Criteria—CAUTI Definition Pocket Cards
CAUTI Surveillance Worksheet
CAUTI Case Review Form
As we wrap up today’s discussion, I’d like to thank you for viewing this presentation. We need all staff’s input to reduce HAIs and CAUTIs in long-term care facilities. The following resources are available to you as participants in the AHRQ Safety Program for Long-term Care: HAIs/CAUTI project. We hope that these resources will be helpful on your journey to reduce CAUTIs and HAIs and improve your facility’s culture of safety.
Resources:
The first resource is a link to the AHRQ Safety Program for Long-term Care: HAIs/CAUTI project website. On the website you will find a variety of tools to help you prevent CAUTIs and improve your facility’s culture of safety.
The second resource is a link to the TeamSTEPPS for Long-term Care web page. TeamSTEPPS is a communication and teamwork system that offers solutions to improving collaboration and communication within health care facilities. The resources on this page are specifically designed for the long-term care environment.
The third resource is a link to NHSN Criteria CAUTI Definition Pocket Cards.
The next resource is a link to the CAUTI surveillance worksheet, designed to assist teams in reviewing a resident’s chart for a suspected CAUTI.
The final resources is a link to the CAUTI Case Review Form, designed to identify possible resident care issues that may have contributed to a CAUTI.

32. References
Centers for Disease Control and Prevention. Healthcare Infection Control Practices Advisory Committee (HICPAC) approved guidelines for the Prevention of catheter-associated urinary tract infections, Available at Centers for Disease Control and Prevention. Identifying Healthcare-associated Infections (HAI) for NHSN Surveillance (online). Accessible at: National Healthcare Safety Network (NHSN). Long-term Care Facility (LTCF) Component Healthcare Associated Infection Surveillance Module: UTI Event Reporting [online]. Stone ND, Ashraf MS, Calder J. Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the McGeer Criteria. Infect Control Hosp Epidemiol 2012;33(10):

33. A New Chapter Suzuki Roshi
“In the beginner’s mind there are many possibilities,
but in the expert’s there are few.”
Suzuki Roshi

34. Thank you!

35. Questions

36. Your Feedback is Important
Remember to Download the Training Materials Designed for All Facility Staff