Robin Haag, RN, BC, MA Director Infection Control/Prevention & HIV Services

Bundle Approach

 Structured way of improving the processes of care and patient outcomes  Straightforward set of evidence-based practices  When performed collectively have been proven to improve patient outcomes

CAUTI Prevention Bundle

 Catheter insertion using sterile technique  Written order for catheter that includes justification  Automatic stop order at 48 hours  Daily review of catheter necessity  Tamper evident seal unbroken (closed system)   Drainage bag lower than patient’s bladder Bag and tubing above the floor  Catheter secured to leg       Free flow of urine  Linen clip  Tubing not kinked or dependent Daily description of urine Remove catheter from patient’s with UTI Daily peri-care and after each bowel movement Patient specific urinal for bag drainage  Urinal cleaned after each use Hand hygiene before and after touch any part of a urinary drainage system

PI Bundle Tool

Check Check Check Check Check

Corrective Actions

 Device Prevalence  Bundle Rounds  Every Day  Every Shift  Interdisciplinary rounds  Assess Need for Catheter  Active Order List ○ ○ HNs Nursing Directors ○ Providers

Education

 Round the Clock   Actual Data Prevention  Competencies  Nursing  Providers ○ Doctors  Housestaff ○ PAs ○ Medical Students  Insertion Observation Form

For the Future

 Ongoing competencies  Bundle PI  Insertion observation  Hospital wide bladder scanning  Only nurses inserting ???

 Mini-RCAs for CAUTIs  Unit Level Accountability ○ Closing the loop ○ ○ Report in Department PI meetings Report to IC/IP meeting

 Robin Haag  (718) 616 - 3106  [email protected]