Background: Prevention of catheter-associated urinary tract infections (CAUTI) is a Department of Health and Human Services Agency Priority Goal. The Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control and Prevention are collaborating to implement the Targeted Assessment for Prevention (TAP) Strategy to reduce healthcare-associated infections by using data to identify and target hospitals with excess infections. As part of the TAP strategy, a CAUTI Facility Assessment Tool was developed and piloted with CMS Quality Improvement Organizations to address gaps in infection prevention.
Objective: To develop and score a CAUTI Facility Assessment Tool.
Methods: An iterative process was used to create a CAUTI Facility Assessment Tool to identify areas for improvement in CAUTI prevention in hospitals. The tool was assessed using Cronbach's alpha, item analysis, and the distribution of scores from four hospitals assessed during the pilot.
Results: The final CAUTI Facility Assessment Tool contained 57 questions in six domains (Figure 1). Domain I, General Infrastructure, contained 25 yes/no questions and creates one subscore (1 point for each Yes). Domains II to VI, CAUTI prevention and urine culturing practices, contained 32 Spector responses (ranging from Never to Always), and creates another subscore (a scaled score with 0 points for Never to 1 point for Always). The total score was a summation of all the points and ranged from 0 to 57.
There were 110 responses from four hospitals, including over 20 units, mostly wards (50%) and intensive care units (43%), with the majority of responses from nurses/certified nursing assistants (69%). The tool was highly convergent with a Cronbach's alpha of 0.89. Mean scores overall and within each domain showed gaps in CAUTI prevention implementation (Figure 1). All scores showed variation; overall scores appeared normally distributed (Figure 2).
Conclusion: The CAUTI Facility Assessment Tool is a highly reliable, internally consistent tool with a normalized distribution of scores to measure CAUTI prevention practices in hospitals. This tool allows for better targeting of prevention interventions to identified areas of need. Evaluation of domain gaps in relation to outcomes is needed.
A. S. Laufer-Halpin, None
R. Welsh, None
A. St. Louis, None
M. Cannon, None
R. Sinkowitz-Cochran, None
C. Gould, None