Table 3.
CAUTI/UTI: Outcomes, Process Measures and Prevention Strategies
| Survey Item | Total (N=51), No. (%) |
Exemplary Quotes |
|---|---|---|
| Aware of CAUTI and UTI rates | ||
| CAUTI rates | 42/49 (85.7) | |
| UTI rates | 46/50 (92.0) | |
| Data collection process | ||
| Collects UTI data, using an electronic health records system | 44/50 (88.0) |
I run a report that’s like an order listing report, and I only do it twice a week. I have 14 different classifications that I run in the report. Then I look at that, look the patient up in the system, make sure that do we meet McGeer’s criteria, what happened? If they don’t, I literally call the nurse and say “hey, I saw that this person you put in an order for Cipro, I don’t see any signs or symptoms. Can you tell me what happened with this patient, what’s going on? [DON NH 2] I do it by hand. Right. I don’t have a program … I’m able to see every order that’s in the system. I go back and I look, and I see who’s having a UA, who has a Foley, and I keep track of those by hand. [IP NH 3] |
| Uses standard definitions to determine whether a resident has UTI (McGeer criteria or CDC NHSN definitions) | 49/49 (100.0) | |
| Uses new antibiotic prescriptions to determine whether a resident has a UTI | 22/45 (48.9) | |
| Reviews provider notes to determine whether a resident has a UTI | 45/50 (89.8) | |
| Share infection data with: | We do feed it back with the staff, but I wouldn’t say we’re the best at sharing with it because we kind of get caught up in the hustle and bustle of day to day. [Administrator NH 2] | |
| NH leadership | 50/50 (100.0) | |
| Bedside nursing staff | 36/50 (72.0) | |
| Residents and families | 16/50 (32.0) | |
| CAUTI and UTI prevention strategies |
I’d say we’re always looking at the patients with Foleys and making sure and discontinuing them if the doctor feels that they’re not necessary. We do education on peri care and how to properly clean the patient. We do lots of hydration, like we pass waters on all 3 shifts. [Administrator NH 2] DON: Yes, we have the—well, it’s in connection with prevention—the cranberry protocol. IP: Right, because they were given … they were giving the cranberry tabs and UTI stat [Cranberry Concentrate with added nutrients for urinary tract health], to everybody who had a urinary tract infection, but it’s not for that. We did just DC—it’s been about a year now—5 long-term people who was on the UTI stat, the cranberry supplements for over a year. I’m tracking them with Dr. [name] to see if they had developed another UTI since the date that they discontinued it and they haven’t, so. [DON/IP NH 3] |
|
| Hydration practices | 42/49 (85.7) | |
| Nurse-initiated indwelling urinary catheter discontinuation | 32/49 (65.3) | |
| Cranberry juice/tablet | 31/49 (63.3%) | |
| Stop orders for indwelling catheters | 24/49 (49.0%) | |
| Multidisciplinary rounds examining indwelling devices | 18/49 (36.7%) | |
| Electronic alerts and reminders of indwelling catheter need | 13/49 (26.5%) | |
| Other (eg, hand hygiene, urology visits, audits) | 11/49 (22.5%) | |
| No prevention strategy | 2/49 (4.1%) |