394. A Multidisciplinary Approach to Reducing Catheter Associated Urinary Tract Infections in the Intensive Care Units Utilizing Link Nurse Program at a Tertiary Care Academic Medical Center
Session: Poster Abstract Session: HAI: Preventing Device-Associated Infections
Thursday, October 27, 2016
Room: Poster Hall
Background: Catheter associated urinary infections (CAUTIs) are one of the most common infections in the Intensive Care Unit (ICU), second only to ventilator associated pneumonia. Given the multidisciplinary nature of infection prevention, it is imperative to engage nurses as collaborators. Based on our previous success in hospital acquired MRSA infections utilizing the LINK nurse (LN) program at a different site, our objective was to develop and employ the program by focusing on reducing CAUTI incidence in ICUs.

Methods: An 8-hour training program trained 27 staff nurses in infection control principles, microbial transmission mechanisms and microbiological testing protocols and specimen collection in September 2014. Trainees represented every patient care unit (PCU) in the hospital. A hospital wide audit of urinary catheter maintenance practices was performed by LN in October 2014. Specific PCU-based tasks relating to CAUTI prevention were assigned to LN during monthly meetings. We measured monthly incidence of CAUTI rate per 1000 Urinary catheter days in ICUs and analyzed reduction in CAUTI rate after implementation of the LINK nurse program using Poisson regression analysis. Of note, because of National Health safety Network (NHSN) definition change for CAUTI surveillance in January 2014, we did surveillance for the entire study period using both old and new definitions.

Results: CAUTI incidence decreased in the intervention period (November 2014 to February 2016 compared to baseline period (January 2012 to October 2014) by 33% from 2.69 to 1.81 cases per 1,000 PD (incidence rate ratio, 0.67; 95% confidence interval: 0.48-0.93, P = 0.016) per new CAUTI definition. Of interest, no difference was noted in CAUTI incidence for the two periods when analyzed using old definition.

Conclusion: LINK nurse program has significantly reduced CAUTI incidence by targeting prevention practices specific to that infection. When used effectively, such a program can help reduce other hospital acquired infections as we noted from past experience and could be used to target other device related infections. New NHSN definition of CAUTI is useful in determining effectiveness of quality improvement programs as opposed to the old definition.

Asma Syed, MD1, Christina Hinkle, RN2, Regina Newman, RN2, Dipika Patel, BS3, Margaret Lewis, RN3, Roman Jandarov, PhD4 and Madhuri Sopirala, MD, MPH5, (1)Infectious Diseases, University of Cincinnati, cincinnati, OH, (2)University of Cincinnati Medical Center, Cincinnati, OH, (3)UC Medical Center, Cincinnati, OH, (4)University of Cincinnati, Cincinnati, OH, (5)Infectious Diseases/Internal Medicine, University of Cincinnati, Cincinnati, OH

Disclosures:

A. Syed, None

C. Hinkle, None

R. Newman, None

D. Patel, None

M. Lewis, None

R. Jandarov, None

M. Sopirala, None

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