CATHETER ASSOCIATED URINARY TRACT INFECTION (CAUTI): A

PREVENTION PLAN

Utilize the Electronic Health Record (EHR) to improve nursing process and patient outcomes.

Education created byKristi Noble MSN RN OCNSeptember 2014

GOAL OF CAUTI PREVENTION

Educate RNs to prevent and reduce the incidence of a CAUTI by:

• Using the EHR to standardize documentation

• Use indications when inserting an indwelling urinary catheter

OBJECTIVES FOR CAUTI PREVENTION

1. Recall the importance of standardizing documentation for in and out times and line days.

2. Identify indications for placing an indwelling urinary catheter.

3. Identify where to locate policies and protocols for an indwelling urinary catheter within the EHR.

REGULATIONS AND REPORTING

DID YOU KNOW?

Since 2008 The Centers for Medicaid

and Medicare Services have not

reimbursed the cost of Hospital

Acquired Infections, such as CAUTI.

Since January of 2013 Munson has

been manually reporting the

instances of patients developing a

CAUTI while in the hospital.

The estimated cost of treating a

CAUTI that develops while in the

hospital ranges from $1,200 to $2,800.

IMPORTANCE OF DOCUMENTING

INDWELLING URINARY CATHETERS IN THE EHR

• Improve patient outcomes• Increase patient safety• Better of tracking patients with an

indwelling urinary catheter• Able to generate reports for

reimbursement• Standardize documentation across

multiple departments and organizations within Munson Healthcare

• Standardize order and discontinue process for indwelling urinary catheter

FOLEY DOCUMENTATION CURRENTLY IN FORMS WILL BE REMOVED AND

MOVED TO INTERACTIVE VIEW

Will move to

I-view

HOW TO ORDER INDWELLING URINARY CATHETER: OLD TO NEW

Nursing is responsible for verifying the presence of a current order. If no order must obtain one.

Indwelling new key word, Foley

can still be used.

NEW REQUIREMENTS FOR INDWELLING URINARY CATHETER

ORDERS:INDICATIONS

Ensure the indications are as accurate as possible

If patient does not meet criteria, they don’t need a urinary catheter

AFTER ORDER IS PLACED

1. Order is placed. RN is notified on tracking shell

2. Go to task list.

3. Double click the Task Description

4. Takes RN to I-view for creation of Dynamic Group

1 2

3

4

CREATING A DYNAMIC GROUP FOR INDWELLING URINARY CATHETER IN

I-VIEW

In creating the dynamic group

there are mandatory

fieldsThe insertion

date is crucial, allows for

tracking of line days to begin.

Date will default forward.

REFERENCE TEXTPOLICIES AND PROTOCOLS

Reference text, protocols, and policies may also be found in Lippincott or policies on the intranet

Reference text with

policies and protocols found by

right clicking on the order

WHEN INDWELLING URINARY CATHETER DISCONTINUED

RNs can discontinue the urinary catheter by right clicking on the order. Providers may discontinue or modify the catheter order by right clicking on the order.

Providers can DC or modify the catheter

order.

WHEN URINARY CATHETER IS DISCONTINUED

1. Go to Task List

2. Double click on task, takes RN to I-view

3. Document discontinuation

1

2

3

DISCONTINUING THE INDWELLING URINARY

CATHETER

The date and time of removal is captured from the time stamp of the column. If not chart at time of removal or back chart correct time.

Once charting complete RN must

inactivate the

dynamic group

STRAIGHT/INTERMITTENT CATHETERIZATION

For patients who require intermittent straight catheterization, a separate dynamic group needs to be created. The same group may be used for each instance of catheterization during the patient’s stay.

Documentation occurs the same as all

other charting in I view

ABC’S OF CAUTI PREVENTION

Adherence to an infection prevention plan

Bladder scan protocol when urinary catheter removed

Condom catheter, access to commode chairs

Do not use catheters unless necessary

Early removal of catheter using the Electronic Health Record as a guide

Your involvement in ensuring that our patients are safe and free from catheter associated urinary tract infections is appreciated, and your care to our patients is invaluable.