+44-1518081136WE “CAUTI” A PROBLEM!
3rd World Congress on CARDIOLOGY AND CARDIAC NURSING
March 25-26, 2019 | Amsterdam, Netherlands
Monette MaboloMoses
Cone Memorial Hospital, USA
Scientific Tracks Abstracts : J Cardiovasc Med Ther
Abstract:
Indwelling urinary catheters are commonly used for heart failure inpatients to support strict intake and output
monitoring related to IV diuretic administrations. In our 30 bed heart failure unit, high indwelling catheter
utilization and high Foley days led to increased Catheter Acquired Urinary Tract Infection (CAUTI). As we drilled
down the problem, we identified inconsistent use of the nurse driven urinary catheter protocol and inaccurate
documentation of I & O. These triggers prompted our team to use the IOWA model to identify best practices in
CAUTI prevention.
Methods/Materials: Using the IOWA model, the team reviewed literature for best practice strategies. Baseline
data on I & O documentation and catheter care practices were collected. Staff were re-educated on the urinary
catheter guidelines, proper Peri and Foley care, use of nurse driven protocol to discontinue Foley catheter and
I&O documentation through daily huddle messages and one on one staff education. Practice was changed in
Intake and Output documentation of catheter output to every 4 hours; Foley/Peri care annual competency was
established and the team selected a Nurse tech and a nurse to be CAUTI champions.
Results: The unit CAUTI rate in 2013 was 3.16 with 7 CAUTI’s and 949 Foley utilization days. After staff re-education
and practice change in 2014, the CAUTI rate decreased to 1.22 with 1 CAUTI and 807 in Foley utilization
days. In 2015 the unit CAUTI rate continued to decline despite a slight increase in Foley utilization of 924 days.
By 2016, the unit continued to be CAUTI free, and YTD they remain CAUTI free with Foley utilization reduced to
350 days.
Conclusion: This evidence based project positively impacted practice by promoting early removal of Foley catheters
and accurate documentation of Intake and output. The results demonstrate a dramatic and consistent decrease
in CAUTI rates, as well as a decrease in catheter days. Adherence to Protocol driven care and commitment
to maintaining increased staff awareness has dramatically reduced the incidence of CAUTI on this department
resulting in the unit’s achievement of 4 years CAUTI free.
Biography:
Monette MaboloMoses completed her doctor degree in nursing practice from American Sentinel University in Aurora, Colorado with a focus in executive leadership. She is currently the director of a 30 bed heart failure unit at Moses Cone Memorial Hospital, a 500 bed acute care hospital that is a part of a 6 hospital enterprise in Southeastern North Carolina. She has presented numerous evidence based posters to various national nursing conferences including the American Nurses Association and the American Association of Critical Care Nurses.
E-mail: Monette.Mabolo@conehealth.com
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