Keeping CAUTI at bay: CMS sponsored program helps cut catheter use and infection

CAUTI is the acronym for Catheter Associated Urinary Tract Infection, the most common of all hospital-acquired infections.graph
In 2012, Hallmark Health System (HHS) joined the CMS-sponsored “Stop CAUTI” initiative to decrease urinary catheter usage and reduce the number of CAUTIs to zero.Urinary catheters are placed in about 25 percent of hospital inpatients and many of these are not essential for a patient’s medical care. “We can’t avoid all urinary catheters,” said HHS Director of Quality and Patient Safety Kathleen Charbonnier, RN, BSN, CCRN, NE-BC. “The key is to place a catheter only when it is clinically indicated – for example, when monitoring urine output for a critically ill patient. Even when a urinary catheter is required for a patient’s treatment, the aim is to remove it as soon as it is no longer medically necessary. The longer a catheter remains in place, the more likely a CAUTI will develop.”

The goal for HHS is threefold: reduce the number of catheter insertions, develop a standardized catheter-removal protocol and eliminate CAUTIs. An interdisciplinary CAUTI team was formed and Med 3 at Melrose-Wakefield Hospital was chosen as the pilot site. The team provided education for all shifts. “We also redesigned our nurse-driven catheter removal protocol and worked with IT to enhance catheterrelated documentation in the EMR,” she said. Other improvements included daily catheter reporting, entering every CAUTI into
RMPro, and instituting a “tracer” system for monthly rounding. While CAUTIs have not yet been reduced to zero, the team
believes it is only a matter of time. “The hospital leadership, our nurses and physicians are all committed to the goal of zero
CAUTIs,” said Charbonnier. 

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