Interventions:The CR consists of 5 hospitals, one of which is a 476 bed tertiary care facility. A CAUTI task force convened to review best practices. In 2012, a daily email was initiated alerting managers of patients with a catheter in place more than 48 hours. Nurse leaders designed education targeting insertion practice, maintenance, perineal care (2013-2014). IPs audited bedside compliance with these practices. Monthly catheter “tips”reminded staff about important aspects of catheter care and maintenance.
Methods: CAUTI data is reported to NHSN per 1000 catheter-days by all study hospitals. Hospital days (HDs) were collected as part of routine reporting. Because the definition of CAUTI changed in 2015 to exclude Candida spp., we increased 2015 CAUTI rates by 15.1% (rate of Candiduria 2012-2014). Rates were compared with a z-score for person-time data.
Results: In 2012, 148 CAUTIs were attributable to CR hospitals, CAUTI rate 3.86 per 1000 catheter days, and CAUTI rate 6.92 per 10,000 hospital days. Catheter-days decreased from 38318 in 2012 to 31743 in 2015 (a 17.2% reduction). Hospital days increased from 213785 to 222985 (a 4.3% increase). Total CAUTIs reduced in CR to 109 (with definition change adjustment, a 26.3% reduction). CR improvements did not result in a significant CAUTI rate reduction: CAUTI rate per 1000 catheter days 3.4; rate ratio 0.93 (0.72, 1.20, p=0.9); however, significant reductions were noted per HDs: CAUTI rate per 10,000 hospital days 4.88, rate ratio adjusted 2015 vs 2012: 0.71 (0.55, 0.9), p=0.005.
Conclusion: IHC’s Central Region CAUTI task force initiated several interventions resulting in significant reductions in both CDs and CAUTI events, not reflected in CAUTI rates. Program evaluation should include CAUTIs per HD to assess intervention effectiveness.
S. Sumner, None
A. Fetzer, None
J. Orton, None
N. Barton, None
S. D. Firth, Medicines Company: Investigator , Research grant
J. P. Burke, None