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Nurses' Knowledge and Compliance to Catheter Associated Urinary Tract Infection Prevention Bundle: A Baseline Survey
E170
American Journal of Infection Control June 2011
Presentation Number 9-087
Nurses’ Knowledge and Compliance to Catheter Associated Urinary Tract Infection Prevention Bundle: A Baseline Survey Karen Singson, RN, MSN, Stephanie Murphy, RN, BSN, Intermountain Healthcare, Urban South Region, Provo, UT; Katreena Collette Merrill, RN, PhD, College of Nursing; Brigham Young University, Provo, UT Background/Objectives: Catheter-Associated Urinary Tract Infection (CAUTI) is the most common HospitalAcquired Infection. Evidence based practice (EBP) recommendations for the prevention of CAUTI provides a framework to decrease these infections. A CAUTI prevention ‘‘bundle’’ was developed to assist front line caregivers with compliance to these standards. Methods: Using a descriptive survey design, a link to an electronic Survey Monkeyä questionnaire about nurses’ knowledge and compliance to catheter care policies was sent through hospital e-mail to 544 registered nurse (RN) and unlicensed assistive personnel (UAP) from 18 departments in three hospitals. A prevalence study was also conducted by infection control practitioners and their trained designees on 99 patients in June 2010 who had indwelling urinary catheters to assess documentation and compliance to urinary catheter protocols. Results: A total of 333 subjects responded to the survey (54.4% response rate). The respondents were 70% RNs and 26.9% UAPs. Almost half (45.6%) reported having less than two years experience. Confidence in placing a urinary catheter in male patients was 7.9 on a 10 point Likert scale (10 highly confident) and 8.1 for female patients. The most common correct catheter care procedures reported included to avoid manipulation (81.4%), retract foreskin (78.8%), remove exudates (75.8%) and rinse and dry the meatus (65.3%, 64.4%). The most common incorrect procedures reported included not securing the device (75.2%), not replacing the catheter after 7 days (74.2%), inappropriate frequency of catheter care (53%), using a product other than soap and water (23.8%) using powder (13.1%), Results of the prevalence study identified compliance to the CAUTI bundle was as follows: Patient education 6.1%, Tubing secured to the bed 19.2%, tubing without dependent loops 34.3%, indications appropriate 65.6%, catheter care documented 65.7%, catheter secured to body 75.8%, tamper seal intact 81.8%, bag not touching floor or over filled (84.8%, 92.9%). Conclusions: Compliance to EBP catheter protocols varies. Education of RNs and UAP is not enough to ensure compliance. Implementation of routine prevalence studies that monitor compliance to a CAUTI bundle is essential in decreasing CAUTIs. Future research on CAUTI prevention bundles and nursing compliance are an integral part of a successful infection control program.
Presentation Number 9-088
A Better Way of Determining Hand Hygiene Compliance by Counting BOTH Entering AND Exiting a Patient Room as One Compliant Episode Kathleen Francis, RN, BSN, Kathleen Lucente, MT, RN, CIC, Infection Preventionist; Paoli Hospital, Paoli, PA Issue: The reported hand hygiene (HH) compliance rates differed from the Infection Preventionist (IP) observed rates. Project: A new IP attended Johns Hopkins Center for Innovation in Quality Patient Care’s HH program. With Hopkins’s permission, the program was introduced in 2010. The campaign included a HH awareness day linked to the World Health Organization (WHO) Campaign for HH. This day included individual unit parties; special items given to employees; hard candy attached to business cards with a HH messages. IPs spoke to/gained support from hospital leaders. The campaign W-Wash/clean hands, I-Identify/isolate early, P-Precautions taking, E-Environment kept clean, S-Share the commitment, raise your hand_abbreviated WIPES)! It is a way to
American Journal of Infection Control June 2011
Presentation Number 9-087
Nurses’ Knowledge and Compliance to Catheter Associated Urinary Tract Infection Prevention Bundle: A Baseline Survey Karen Singson, RN, MSN, Stephanie Murphy, RN, BSN, Intermountain Healthcare, Urban South Region, Provo, UT; Katreena Collette Merrill, RN, PhD, College of Nursing; Brigham Young University, Provo, UT Background/Objectives: Catheter-Associated Urinary Tract Infection (CAUTI) is the most common HospitalAcquired Infection. Evidence based practice (EBP) recommendations for the prevention of CAUTI provides a framework to decrease these infections. A CAUTI prevention ‘‘bundle’’ was developed to assist front line caregivers with compliance to these standards. Methods: Using a descriptive survey design, a link to an electronic Survey Monkeyä questionnaire about nurses’ knowledge and compliance to catheter care policies was sent through hospital e-mail to 544 registered nurse (RN) and unlicensed assistive personnel (UAP) from 18 departments in three hospitals. A prevalence study was also conducted by infection control practitioners and their trained designees on 99 patients in June 2010 who had indwelling urinary catheters to assess documentation and compliance to urinary catheter protocols. Results: A total of 333 subjects responded to the survey (54.4% response rate). The respondents were 70% RNs and 26.9% UAPs. Almost half (45.6%) reported having less than two years experience. Confidence in placing a urinary catheter in male patients was 7.9 on a 10 point Likert scale (10 highly confident) and 8.1 for female patients. The most common correct catheter care procedures reported included to avoid manipulation (81.4%), retract foreskin (78.8%), remove exudates (75.8%) and rinse and dry the meatus (65.3%, 64.4%). The most common incorrect procedures reported included not securing the device (75.2%), not replacing the catheter after 7 days (74.2%), inappropriate frequency of catheter care (53%), using a product other than soap and water (23.8%) using powder (13.1%), Results of the prevalence study identified compliance to the CAUTI bundle was as follows: Patient education 6.1%, Tubing secured to the bed 19.2%, tubing without dependent loops 34.3%, indications appropriate 65.6%, catheter care documented 65.7%, catheter secured to body 75.8%, tamper seal intact 81.8%, bag not touching floor or over filled (84.8%, 92.9%). Conclusions: Compliance to EBP catheter protocols varies. Education of RNs and UAP is not enough to ensure compliance. Implementation of routine prevalence studies that monitor compliance to a CAUTI bundle is essential in decreasing CAUTIs. Future research on CAUTI prevention bundles and nursing compliance are an integral part of a successful infection control program.
Presentation Number 9-088
A Better Way of Determining Hand Hygiene Compliance by Counting BOTH Entering AND Exiting a Patient Room as One Compliant Episode Kathleen Francis, RN, BSN, Kathleen Lucente, MT, RN, CIC, Infection Preventionist; Paoli Hospital, Paoli, PA Issue: The reported hand hygiene (HH) compliance rates differed from the Infection Preventionist (IP) observed rates. Project: A new IP attended Johns Hopkins Center for Innovation in Quality Patient Care’s HH program. With Hopkins’s permission, the program was introduced in 2010. The campaign included a HH awareness day linked to the World Health Organization (WHO) Campaign for HH. This day included individual unit parties; special items given to employees; hard candy attached to business cards with a HH messages. IPs spoke to/gained support from hospital leaders. The campaign W-Wash/clean hands, I-Identify/isolate early, P-Precautions taking, E-Environment kept clean, S-Share the commitment, raise your hand_abbreviated WIPES)! It is a way to