Reduction of CAUTI Events in an ICU During the COVID-19 Pandemic Through Shared Governance and Using Process Improvement Strategies

BACKGROUND: Catheter Associated Urinary Tract Infections (CAUTIs) are associated with an increase in mortality, morbidity, length of stay, and hospital costs. Intensive Care Units (ICUs) have higher rates of CAUTIs than other hospital units. During the Coronavirus (COVID-19) pandemic, Hospital Associated Infections (HAIs) have increased, including a 30% increase in CAUTI events within ICUs nationwide. The aim of this project was to engage the frontline staff in reducing CAUTI rates in the ICU. METHODS: This project occurred on a 40 bed Intensive Care Unit (ICU) in a 350+ bed community hospital. The patient population included patients positive for COVID-19. The Shared Leadership Council (SLC), which comprised of both unit leadership and frontline staff, utilized Plan-Do-Check-Act (PDCA) framework to reduce the incidence of CAUTIs on the unit. Peri-care and catheter care was identified as a gap in recent CAUTI events. The SLC developed a 4-pronged approach to include: hand hygiene cues, peri-care and catheter care training, CAUTI prevention bundle and external device review, and Patient Care Assistants (PtCA) to champion and standardize catheter and peri-care in daily unit workflow. RESULTS: The result was a reduction in the number of CAUTI events in the ICU during 2021 from 3 in Quarter 1, to 2 in Quarter 2, to 0 in Quarter 3. CONCLUSIONS: These results support success in engaging front line staff in Process Improvement Projects aimed at reducing HAIs. The SLC identified opportunities to close CAUTI prevention bundle element gaps, developed a set of interventions, and executed the interventions in the ICU.