Does our bundle stack up! Innovative nurse-led changes for preventing catheter-associated urinary tract infection (CAUTI)
Michelle Giles A B , Wendy Watts C , Anthony O’Brien A B , Sandy Berenger D , Michelle Paul E , Karen McNeil A and Kamana Bantawa A F
+ Author Affiliations
- Author Affiliations
A Nursing and Midwifery Research Centre, Hunter New England Local Health District, Newcastle, NSW 2310, Australia.
B School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia.
C Urology Royal Newcastle Centre, Hunter New England Local Health District, Newcastle, NSW 2310, Australia.
D Infection Prevention and Control (IPCU), Hunter New England Local Health District, Newcastle, NSW 2310, Australia.
E Continence, Hunter New England Local Health District, Newcastle, NSW 2310, Australia.
F Corresponding author. Email: kamana.bantawa@hnehealth.nsw.gov.au
Healthcare Infection 20(2) 62-71 https://doi.org/10.1071/HI14035
Submitted: 22 October 2014 Accepted: 2 March 2015 Published: 21 April 2015
Journal Compilation © Australasian College for Infection Prevention and Control 2015
Abstract
Introduction: The aim of this project was to develop and implement an innovative nurse-led model of care in the use and management of indwelling urinary catheters (IUC) utilising evidence-based ‘bundle interventions’ to reduce the incidence of catheter-associated urinary tract infections (CAUTI).
Design and method: A pre and post intervention study designed to progress in three phases was conducted in the orthopaedic ward and urology ward of a large tertiary referral facility. Phase one involved a clinical data collection pre intervention on all inpatients receiving an IUC over a 3-month period from February to April 2013. A staff survey assessed knowledge and skills and an evidence-based care bundle, nurse-led protocols, and education resources were developed through collaboration with clinicians. Phase two involved implementation and Phase three was an evaluation with the primary outcome targets being reduced IUC usage, days IUC in situ and incidence of CAUTI.
Results: Pre audit data revealed a high rate of IUC use: 31% of all inpatients in the orthopaedic ward and 25% in the urology ward. Compliance with current guidelines was inconsistent and documentation related to IUCs was poor. Overall CAUTI rate was relatively low at 2.2% of all patients with an IUC and was higher in the orthopaedic ward.
Conclusion: The development of a systematic and standardised approach to IUC care for inpatients using bundle care interventions will potentially reduce IUC use, provide a clear pathway for nurse-initiated IUC removal and reduce the incidence of catheter-associated urinary tract infections (CAUTI).
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