Reducing urinary catheter use and catheter-associated urinary tract infections can be challenging in the engagement, education, execution and evaluation phases, but there are several solutions, according to a report in Infection Control and Hospital Epidemiology.
The authors presented 10 common barriers and solutions to CAUTI prevention, adapted from www.catheterout.org:
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Engage
1. Nurses are not on board.
Solution: Gain buy-in before implementing the program.
2. Physicians resist the change.
Solution: Provide data on urinary catheter use and CAUTI rate, and identify a physician champion to gain support among colleagues.
3. Leadership does not prioritize CAUTI.
Solution: Present a business case using CMS' nonpayment rule and public reporting of CAUTI.
Educate
4. Healthcare workers have gaps about consequences of urinary catheter use.
Solution: Develop a multimodal educational campaign, and assess understanding.
Execute
5. Catheters are often used unnecessarily.
Solution: Develop a policy on appropriate catheter placement.
6. Catheters are not taken out in a timely manner.
Solution: Incorporate daily catheter evaluation into workflow.
7. Proper insertion technique is not followed.
Solution: Develop or update the catheter insertion policy, and consider periodic audits of placement.
8. Healthcare workers identify a lack of needed resources.
Solution: Build capacity, and consider using electronic medical records to prompt evaluation or removal of the catheter.
Evaluate
9. Although compliance with protocols increases, urinary catheter use does not decrease significantly.
Solution: Assess changes in the patient population, and examine data related to labeled indications for accuracy.
10. National Healthcare Safety Network CAUTI rate does not decrease despite a decrease in catheter placement.
Solution: Examine the urinary catheter utilization ratio to determine catheter use changes per number of patients; then compare use with the population-based CAUTI measure.
More Articles on CAUTIs:
5 Components of a Nationwide CAUTI Reduction Initiative
Patient Safety Tool: Stop CAUTI Implementation Guide
7 Keys to CAUTI Reduction
