Florida Hospital Maintains Zero Rates for CAUTI and CLABSI

August 25, 2022

Keralty Hospital is a 125-bed hospital located in Miami, FL and a top performer in Catheter Associated Urinary Tract Infections (CAUTI) and Central Line Associated Blood Stream Infections (CLABSI) prevention.

According to the NHSN data, Keralty Hospital is currently maintaining a zero rate for both CAUTI and CLABSI. If a CAUTI and CLABSI is reported, a root cause analysis is completed. Regarding device utilization, Keralty Hospital has improved 41.9% over 2019 baseline for Catheter Utilization Ratio Per Patient Day and maintaining low rates for Central Line Utilization Ratio Per Patient Day near 2019 baseline (3.35%) and reported lowest ratio to date (0.72%) in March 2022.

Gretel Herrera, Infection Preventionist at Keralty Hospital reports that the following interventions have contributed to their achievements and success.

  1. Nurse driven protocol to avoid CLABSI and CAUTI
  • avoid catheter if possible
  • ensure aseptic placement
  • maintain awareness and proper care of catheters in place, and
  • promptly remove unnecessary catheters

Specifically to avoid CLABSI, nurses maintain a closed system, scrub access ports (needleless caps) with antiseptic solution (70% alcohol) for at least 15-20 seconds before access and the use intermittent infusion caps of luer-lock design to ensure a secure junction.

Specifically to avoid CAUTI, nurses do screening and assessment and evidence-based management of urinary retention and incontinence, this is essential to reduce catheter overuse. Nurses use aseptic technique during catheter placement. Additionally, to prevent CAUTI nurses take special consideration for proper hand washing and not using urine drain tubes and if they must be used, inserting them properly and keeping them clean. Catheters are utilized only when necessary and removed as soon as possible.

  1. Daily assessment or rounds- Infection Control nurse does rounds daily to check and do an assessment on central lines and Foley catheters in the hospital. This is documented two times during the week using survey tools and forms.
  2. Staff education/competence for insertion and maintenance – In-services completed by Infection Control nurse according to schedule. If any action or correction is needed, 1:1 education is provided to the nurse caring for the patient.