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Northeast Alabama Regional Medical Center is part of the Regional Medical Center (RMC) located in Anniston, AL. It is comprised of two campuses, NEARMC, a 338-bed hospital and Stringfellow, a 125-bed hospital.

According to NHSN data, NEARMC has been maintaining zero rates for both CAUTI SIR All Units and CLABSI SIR All Units since November 2021. In addition, there are currently downward trends in both Catheter Days per Patient Day and Central Line Days per Patient Day.

Debra Holmes, RN, BSN, CCDS, Director of Case Management/Quality/Social Services/CDI contributes their success to the multidisciplinary Hospital-Acquired Infection (HAI) team. Their team consists of Nursing leadership and management, Quality, Infection Prevention and Medical Staff. The HAI team meets every two weeks or more often to conduct a root cause analysis on each failure and apply inclusion/exclusion criteria. The team decides as a group if it is a true reportable CAUTI/CLABSI.

After the team reviews the data, they “shop at The Gaps” to identify and implement interventions which include the challenges and solutions listed here.

Congratulations to NEARMC and RMC/Stringfellow for showing resilience throughout the pandemic to improve CAUTI and CLABSI outcomes. See Northeast Alabama Regional Medical Center’s webinar presentation recorded on September 27, 2022.

Data from the Centers for Disease Control and Prevention (CDC)’s National Healthcare Safety Network (NHSN) show a significantly higher incidence of catheter-associated urinary tract infections (CAUTIs) in 2021 compared to 2019. Since the COVID-19 pandemic, prevention of CAUTIs remains a patient safety priority in hospitals to reduce patient harm and costs and improve outcomes.

This presentation will feature real world examples of effective CAUTI prevention strategies shared by Alaska Native Medical Center and Campbell County Health infection prevention leaders. Our speakers will share their experiences developing staff education, optimizing surveillance, engaging physician champions and much more!

It’s time to celebrate! Join this exciting presentation and discussion to learn how hospitals improved their processes and outcomes during their six-month cohort participation. Each cohort reviewed data and implemented improvements based on the most effective interventions among HQIC enrolled hospitals. Hospital cohorts began in May/June and included the following patient safety topics:

  • Readmissions and Health Equity
  • Adverse Drug Events (ADEs)
  • CAUTI/CLABSI
  • MRSA
  • Sepsis
  • Over 20 Opioid Safety Tools and Guides
  • Includes Opioid Taper Decision Tool
    • Example Tapers
    • Chart with short-term oral medications that can be used to assist with withdrawal symptoms

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.

OVERVIEW:

Data from the CDC’s National Healthcare Safety Network (NHSN) show a significantly higher incidence of catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs) in 2021 compared to 2019. Since the COVID-19 pandemic, prevention of CAUTIs and CLABSIs remains a patient safety priority in hospitals to reduce patient harm and costs and improve outcomes.

Join this exciting presentation and discussion to learn how Northeast Alabama Regional Medical Center changed its healthcare-associated infection (HAI) review process from one person to a group of clinical and health care professionals, resulting in better outcomes in CAUTI and CLABSI prevention. This is Part 1 of a two-part series on strategies to prevent CAUTI. Part 2 webinar will be held in October.

LEARNING OBJECTIVES:
1. Understand how changing the HAI review process resulted in better patient outcomes
2. Gain insight into how the Root Cause Analysis process is used to identify missed opportunities to prevent CAUTI and CLABSI
3. Learn how the team “shops at The Gaps” to implement best practice interventions