Authors (including presenting author) :
Siu LF, Chan KW, Chu HC, Tang HL
Affiliation :
Department of Medicine, Yan Chai Hospital
Introduction :
Urinary tract infection (UTI) is a commonly hospital-acquired infection, and majority UTI cases are associated with an indwelling urinary catheter (Trautner, 2010). Banks, Abdella and Willmann (2016) show that mortality, morbidity, length of hospital stay and cost of care are increased in CAUTI case. Moreover, CAUTI is the most frequent cause of secondary healthcare-associated bloodstream infection, in which carrying an approximate 10% mortality rate (Rebmann and Greene, 2010). In Hospital Authority (2011), UTI is the second most common infection of hospital acquired infections (HAIs). Refer to bacteremia MRSA rate in Yan Chai Hospital, there are 3 cases out of 14 cases of bacteremia from the period of January to June in 2018. Root Cause Analysis is conducted and found that the primary source is urosepsis. Therefore, a quality improvement programme is conducted to enhance appropriate care of urinary catheter and to reduce the risk of CAUTI.
Objectives :
1. The risk of catheter-associated urinary tract infection is reduced.
2. A reminder system to identify and remove urinary catheter as soon as no longer indicated is implemented.
3. Proper insertion and maintenance of urinary catheter is ensured.
Methodology :
In order to improve preventative care to patient with an indwelling urinary catheter, bundle of care was implemented (Center for Health Protection, 2017 & Association for professionals in Infection Control and Epidemiology, 2008): - Adherence to hand hygiene
- Proper aseptic technique for urinary catheter insertion
- Maintain a sterile & closed urinary drainage system
- Routine daily cleansing of meatal area
- Reminder form to daily review the indication for urinary catheter & nurse remind physician to remove catheter when no longer indicated
Result & Outcome :
- An educational talk about HA-CAUTI bundle care was provided to all nursing staff of B14S on 28th and 29th August, 1st, 4th and 13th September.
- An educational talk about proper empty urinary bag procedure on 23rd and 27th August. All of them passed in the post education assessment.
- For male patient with an indwelling urinary catheter is included in the study, regardless of long term Foley or newly inserted case, pre-intervention data was collected from 14S (intervention ward) and 13S (control ward) ward separately. There was no HA-CAUTI case reported in the invention ward. Nevertheless the result was not statistically significant due to time limitation and small sample size. Finally, the use of reminder form and daily meatal care were successfully introduced to the intervention ward. The CAUTI bundle care to promote patients’ health during their hospitalization, and patients’ meatal hygiene was sustained. Moreover, staffs’ inappropriate practice had improved after this program.
Co-location with:
