Authors (including presenting author) :
LAU CH(1), L CHEUNG LY(1), LAM YWS(5), KUNG CC(1), MA MS(1), WONG CS(1), CHUI WST(1), LEE SPP(4), KWOK MLA(3), LO RSK(2)
Affiliation :
(1)Palliative Care Unit, Shatin Hospital, (2) Palliative Care Unit, Bradbury Hospice/Shatin Hospital, (3) CND, Bradbury Hospice/Shatin Cheshire Home/ Shatin Hospital, (4) Medical & Geriatric, Shatin Hospital, (5) Infection Control, Shatin Hospital
Introduction :
Appropriate nursing care of urinary catheter is crucial in preventing catheter related urinary tract infection (CAUTI). In addition, the engagement of health care worker in local level is critical, effective; include training and coaching support of daily care practice (Fakih, et al., 2014). The CAUTI rate in palliative care ward increased from 2017(7.66%), to mid-2018(12.53%). However, management had noted a spike of ESBL infection on March 2018. There was also a significant staff turnover, with 40% of nursing staff & 20% of care assistant new to service. The staff education need identified in basic care. Management believed that CAUTI prevention is about basic, simple care; education is an investment and ignorance is expensive. (Kilgore, 2017)
Objectives :
Aim to decrease the CAUTI rate, identifying the areas for improvement, which serve as a guide for the coaching and education to staff and review their compliance on urinary catheter care afterward.
Methodology :
1. Early April 2018, catheter care enhancement team set up, with frontline and infection control nurses. 2. Practice review about care of urinary catheter on nurses and care assistants, identified four areas for training, empty urine bag, napkin change, swabbing of urinary catheter and catheter change. 3. April, 2018, delivered talks on the procedures and all staff viewed the education videos, with return demonstration to supervisors. Onsite coaching of daily work was given, during the interval between trainings & audits. 4. May 2018, a follow up audits conducted. 5. October 2018, audit results, identified improvement areas were shared with staffs. 6. January & February 2019, infection control nurses had given talks on catheter care to nurses, physicians and care assistants; aim to enhance the practice of minimize patients’ use of urinary catheter, and further reinforce the catheter care.
Result & Outcome :
1. After a series of training & coaching, CAUTI rate decreased from 12.53% in Jan 2018 to 2.79% in Dec 2018. 2. Staff expresses increased awareness on the prevention of CAUTI and the importance of infection control. 3. There are further plan with physicians’ participation, to minimize the catheter days of patient with urinary catheter.
Co-location with:
