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Reducing Urinary Tract Infection/Catheter Associated UTI Rates at Richmond Hospital
Melanie Rydings & Lisa Stewart on behalf of the RH UTI/CAUTI Working Group
Aim Statement
The Work
Qualitative Outcomes
Problem:
Year to date (2014-15) rates of urinary tract infections among
inpatients at Richmond Hospital are 12.6 per 1,000 discharges.
Process Map Insert Here!
UTIs are the most common Hospital Acquired Infection within
Vancouver Coastal Health accounting for 18,900 cases in the past
4 years. The literature suggests that 80% of these are related to
urinary catheter placement.
Poster: for staff and pts maybe?
Pre/ Post Catheter Care & Maintenance Education for Allied Health:
Correct Answers are consistently higher post education
NSAE: CAUTI - Richmond Quality Urinary Care
Allied Health/Porters Quiz Post-Test Results October 2014
NSAE: CAUTI - Richmond Quality Urinary Care
Allied Health/Porters Quiz Pre-Test Results October 2014
100
100
83.4
80
60
80
%
Goals:
All RH patients with catheters have an appropriate and
documented indication.
60
59.0
%
40
40
20
20
0
0
Question 1 Question 2 Question 3 Question 4 Question 5 Question 6 Question 7 Question 8 Question 9 Question 10
Question 1 Question 2 Question 3 Question 4 Question 5 Question 6 Question 7 Question 8 Question 9 Question 10
Clinicians and support staff provide appropriate and evidence
based Care & Maintenance to catheterized patients.
Word on the Units
To reduce the Richmond Hospital UTI rate by 25% by September
2015 as measured by Discharge Abstract Database (DAD).
Catheters are definitely coming out sooner now that we review them in daily rCARE
rounds. Sarah Suozzi, PCC 2 Medicine Telemetry.
High Level Strategy
I now make sure there is a clear clinical indication before ordering a urinary catheter
for a patient. Richard Chan, MD, CCFP (EM), Department Head ED Richmond Hospital
Developing a sustainable process by which catheter indication is
reviewed daily by interdisciplinary care teams: rCARE and physician
rounds.
I have many patients all over the hospital and this process is an easy way to track
which of my patients have catheters. I wish we had this process for central lines. Dr.
Sharadh Sampath, Head, department of surgery, Vancouver Coastal Health –
Richmond
Provide evidence based care and maintenance education to clinicians
and support staff including nursing, allied health, and patient
transport.
I had no idea that how I was supposed to manage catheters while I was mobilizing
patients. I was really glad to see Allied Health included in this Education. Teresa
Green, Clinical resource Therapist, VCH.
Promote involvement of patients and families in the Care and
Maintenance of their indwelling catheter.
Next Steps and Sustainability
Create Visual tools to:
•Provide a method for documenting catheter insertion and indication
•Identify patients on the units with indwelling catheters
•Track how many day s the catheter has been in
•Alert physicians of the presence of an indwelling catheter
•Provide physicians with a method for documentation and
communication of indication and/or removal.
Education to support VCH-U-1030: Intermittent Urinary Catheter, Procedure
for Insertion and CPD U-050 Retention Algorithm
Introduction of a Daily Care and Maintenance Documentation Tool:
Outcome Measures
•Discharge Abstract Data and NSQIP UTI Rates
•Number of patients with catheters with appropriate indication and
documentation.
Acknowledgements
CAUTI Working Group: Richmond Hospital
Kenneth S Poon, MD FRCSC (Urology)
Michael McAuley, Director Quality and Patient Safety, VCH Richmond
Barb Drake, Clinical Quality & Safety Coordinator
Contact: [email protected] and [email protected]