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

Disclosures

Nurs Econ. 2017;35(3):134-141. 

In This Article

Outcome Measures

Quality Outcomes

Improving data was imperative as the hospital is the largest within Northwell Health, which can significantly impact overall data by an average 25%. Both the hospital and health system demonstrated substantial reductions in ICU CAUTI measures defined as ICU CAUTI SIR, ICU CAUTI incidence, ICU catheter days, and cost impact. The project began year-end (YE) 2013 and continued through YE 2014 (12-month period) concluding June 30, 2015 (18-month period).

Over the 12-month period, hospital data demonstrated a decline in ICU SIR of 32% and in 18 months expressed a 73% reduction (see Figure 3). ICU CAUTI incidence decreased by 46% and 89%, while catheter days decreased by 22% and 58% respectively (see Figure 4). As the hospital's ICU CAUTI measures continued to decline, the health system also had similar reductions. Health system ICU SIR declined by 22% over the 12-month period and reduced by 57% over the 18-month period. ICU CAUTI incidence declined 28% and 81% respectively, while ICU catheter days dropped 11% and 56% respectively (see Figure 5).

Figure 3.

NSHU and Northwell Health ICU SIR Rates
NSUH = North Shore University Hospital, CMS = Centers for Medicare & Medicaid Services, ICU = intensive care unit, SIR = standardized infection ratio

Figure 4.

NSHU and Northwell Health ICU CAUTI Incidence
CAUTI = catheter-associated urinary tract infection, NSUH = North Shore University Hospital, ICU = intensive care unit

Figure 5.

NSUH and Northwell Health Catheter Days
NSUH = North Shore University Hospital, ICU = intensive care unit

In 2015, additional resources were deployed to hospital non-ICU units as improvement in data lagged slightly behind ICU outcomes. These resources included the purchase of additional bladder scanners and education to both CAUTI ambassadors and staff. Non-ICU SIR declined by 10% over the 12-month period and 27% over the 18-month period. Non-ICU CAUTI incidence was reduced by 25% within 12 months and 68% in 18 months. Likewise, there was a 9% and 54% decrease in catheter days over the 12 and 18-month periods. Although, the health system non-ICU SIR increased by 16% over 12 months, by 18 months the health system demonstrated a 24% reduction. Non-ICU CAUTI incidence experienced a slight 3% increase over 12 months but decreased 63% by 18 months. Lastly, non-ICU catheter days decreased by 10% in 12 months and 53% in 18 months.

Financial Impact

As quality care continues to remain a priority, institutions must not lose sight of the financial impact associated with CAUTIs. North Shore University Hospital demonstrated reductions in ICU CAUTIs which translate into a 46% cost savings over a 12-month period equating to $62,396 and an 89% savings over 18 months with a value of $119,866. Northwell Health has reduced ICU-related CAUTI costs by 28% over 12 months equating to $110,014 and 81% over 18 months with a value of $316,906 (see Figure 6). These savings are necessary in the prevention of complications currently under payment reforms. As such, institutions must be ready to invest in strategies to reduce CAUTIs.

Figure 6.

NSUH and Northwell Health ICU CAUTI Direct Cost (est. $1,642/CAUTI)
CAUTI = catheter-associated urinary tract infection, NSUH = North Shore University Hospital, ICU = intensive care unit

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