The nurses were provided online and floor education about the proper use of the protocol. A two-month pilot was initiated on a few floors to include the nurse-driven removal protocol as a default setting, with the ordering provider given two other choices for removal: time/condition or assessed by the provider (Dy, 2016). Then, the protocol was implemented across all three hospitals with the protocol as a default setting. When combining data from all three hospitals, the author reported no significant change in indwelling catheter use. However, there was a 19% reduction in CAUTI per 1,000 catheter days among the three hospitals (Dy, 2016). It is important to note that the hospital that had the highest adoption of the protocol had a reduction in catheter use of 6% and a decrease in CAUTI of 28% (Dy, 2016). The hospital with the lowest adoption of the protocol had no change in catheter use or CAUTI rates. The author reports that the success of this project is credited to the support of leadership and strong engagement from all involved in patient care. This article is evidence that with education, dedicated staff, and strong leadership support, a nurse-driven protocol will help decrease urinary catheter use and decrease CAUTI rates. “Implementation of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in four Australian hospitals: A pre- and postintervention study” This Australian study is a Level III, Quasi-Experimental Study. Its design was a cluster- controlled pre- and post-study looking to reduce the use and duration of indwelling urinary catheters by implementing a nurse-led care bundle in four acute care hospitals. The implemented
Translational Research 8 care bundle used the acronym “NOCAUTI” (need, obtain, competency, asepsis, unobstructed, timely, infection risk) (Giles, et al., 2019). Before implementation and during the first month of use, nurses were educated about using the bundle. For six weeks, a 27-question audit for adherence to the “NOCAUTI” bundle was performed and then continued monthly. An online staff survey was used before and after the implementation to gauge nurse attitudes and perceptions toward preventing CAUTI. The authors report that implementing the “NOCAUTI” bundle resulted in a remarkable reduction of short-term indwelling catheter use. According to this study, when applied to all public hospitals in Australia, the “NOCAUTI” bundle has the potential to avoid 2% of indwelling catheter insertions, potentially 131,747 catheters (Giles, et al., 2019). The online surveys also revealed that post-intervention there was a positive change in attitude and culture towards CAUTI prevention (Giles, et al., 2019). The authors did note that regular audits to monitor for bundle compliance would be important for long term success. This study demonstrates that implementing a nurse-led care bundle will positively impact short-term urinary catheter use and foster a better culture of focus on CAUTI prevention.
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- Spring '18
- Nursing, urinary tract infection, Catheter, Urinary catheterization, Foley catheter, urinary catheter