Saving Lives and Reducing Harm: A CAUTI Reduction Program

Kerri Ann Scanlon, MSN, RN; Celia M. Wells, PhD(c), RN; Launette Woolforde, EdD, DNP, RN-BC; Aradhana Khameraj, MSN, RN; Jennifer Baumgarten, MBA


Nurs Econ. 2017;35(3):134-141. 

In This Article

Outcome Measurements

Quantitative measures and formative evaluation processes were used to determine success of the program. Data collection for this project included measures of standardized infection ratio (SIR), incidence, and catheter days for both NSUH and Northwell Health in the intensive care (ICU) areas. The HAI data uses SIR, a summary statistic, to measure relative differences in HAI occurrence reporting during a common referent period (e.g., standard population) (CDC, 2010). In HAI data analysis, SIR compares the actual number of HAIs with the predicted number based on the reference point of the standard population, adjusting for risk factors most associated with differences in infection rates (CDC, 2010). SIR is used as an index to measure infection performance, calculated by dividing the number of observed infections by the number of expected infections (CDC & NHSN, 2013). It is very difficult to reduce the SIR as there are many factors considered in its computation. A significant infection reduction is required to impact the SIR. Incidence refers to the actual number of confirmed CAUTIs while indwelling catheter days is an ongoing number that reflects the daily count of patients with indwelling urinary catheters in a specific patient care location (CDC & NHSN, 2013).

Catheter days are important since a reduction in indwelling catheter days indicate opportunities for early removal and insertion prevention. Outcomes were directly related to a series of educational programs which focused on care for patients with indwelling catheters. These programs (nurse-driven algorithm, dry bag concept, perineal care practices, maintenance and insertion techniques, two RN mandate, development of CAUTI ambassadors, and use of a CAUTI acronym) provided nurses with the knowledge and support necessary to affect change at the bedside, resulting in achievement of the objectives. Most importantly, outcomes were nurse driven, directly impacting patient satisfaction, financial performance, and quality and safety, which were quantified by a reduction in infections on both the hospital and health system levels.