2014 Performance Improvement Project Kevin Pham, Huy Tran, Lawrence Kim, Tiffany Nguyen, Fady...

2014 Performance Improvement Project

Kevin Pham, Huy Tran, Lawrence Kim, Tiffany Nguyen, Fady Youssef (And Aceela Muqri) | September 9, 2014

CAUTI and VA Nursing Documentation

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FOCUS

F – finding the problem

O – organize resources

C – clarify goals

U – understand objectives

S – select a plan

Department of Medicine| September 9, 2014

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Problem

•Benefits vs risks

•Personal experiences

•Documentation


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2009 International Clinical Practice Guidelines from IDSA

“Institution should consider nurse-based or electronic physician reminder systems to reduce inappropriate urinary catheterization (A-II) and CA-UTI (A-II).”

IDSA Guidelines


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•Computer documentation

•Decreased duration

•No change in re-cath rate

Cornia PB, Amory JK, Fraser S, et al. Computer-based order entry decreases duration of indwelling urinary catheterization in hospital- ized patients. Am J Med 2003;114:404-407.


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Our Resources

•Long Beach Veteran Affairs Medical Records (CPRS)

•Nursing management staff

•Residents

•Attendings


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Goals and Objectives

Objective:

To improve the rate of catheter-associated urinary tract infections

Primary Outcome:

The rate of Foley insertion documentation of pre-intervention compared to post-intervention samples.


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Project Challenges

•Compliance from nursing staff

•Accuracy of documentation• Multiple insertions


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Opportunity Statement

•An opportunity exists to improve:•Documentation of Foley’s

•Why?•Reduces UTI

•Goal?•increases by 10% or greater

Department Name | Month X, 201X

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PDCA

• Plan

• Do

• Check

• Act

Department Name | Month X, 201X

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Pre-Intervention (PLAN)

• Team members collected rates of documentation of Foley placement once a month for 5 months

• Documentation consisted of a Foley insertion note entered by the patient’s RN

• Spreading out the data collection was intended to eliminate possible variations


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Intervention (DO)


• Poster Design

• Nursing huddle

13 Department of Medicine| September 9, 2014

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Post-Intervention (CHECK)

• Team members collect rates of documentation of Foley placement

• Multiple Sample Days


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Outcome

Pre-intervention sample: N= 25

Post-intervention sample: N= 23


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Pre Vs Post Data


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Data Analysis

•The sample size is too small to demonstrate statistical significance.

•The raw data suggests an improvement in the rate of documentation of Foley insertion note after our intervention.

•Additional data collection may enhance the effect of our observed outcome.

•However, additional data collection requires a longer period of investigation, which is not feasible for this current project.


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Data Analysis






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Data Analysis






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Outcome


We improved nursing documentation for Foley catheter placement with a simple educational intervention with the hope

of reducing the rate of CAUTI at the VA.

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Thank You!


2014 Performance Improvement Project Kevin Pham, Huy Tran, Lawrence Kim, Tiffany Nguyen, Fady...

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