When Amy Davenport, BSN, RN, and Kimberly McGovern, BSN, RN, PCCN, identified an increase in CAUTI cases on Shapiro 9W/10EW adult non-intensive care units, they worked with both their Unit-Based Practice Council (UBPC) and the CAUTI Prevention Task Force to understand the cause and address it.
The UBPC clinical nurse members, together with Debra Pelletier, MSN, RN, nursing director, Amy Bulger, MPH, RN, CPHG, nursing program director and CAUTI Prevention Task Force co-chair, and Infection Preventionist Robert Tucker, MPH, CIC, completed chart audits to determine that these CAUTI cases were due to catheter maintenance rather than insertion practices.
The team developed a CAUTI Prevention Checklist, approved by both the UBPC and the CAUTI Prevention Task Force, focused on evidence-based maintenance interventions, including:
- placing the drainage bag below the bladder
- ensuring the drainage bag is off the floor
- securing catheter tubing properly with the green clip and ensuring that there are no kinks or loops in the tubing
- performing Foley care daily and as needed and documenting it in the flowsheet every shift
- discussing continued catheter placement and use of alternatives daily or more frequently
UBPC members also provided education on the importance of proper indwelling urinary catheter maintenance and removal using the nurse-driven protocol.
After these interventions, the Shapiro 9W/10EW CAUTI rate per 1,000 catheter device days decreased from 5.0 in Feb. 2019 to 0 in May–Dec. 2019.
Why It’s Magnet: Magnet requires an example of clinical nurses improving patient safety as part of the Exemplary Professional Practice component (EP16) of the Magnet model. This is one of many examples throughout the Brigham demonstrating how nurses work together to improve patient safety. It’s who we are.
Additional members of the UBPC and CAUTI Prevention Task Force who participated in these efforts include: Elizabeth Harmon, BSN, RN; Lauren Mahoney, BSN, RN; Jacqueline Dow, MSN, RN; Amy Taylor, BSN, RN; Andrea Brea, BSN, RN