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Western Governors University Emergency Department Project Proposal Discussion

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Project is reduction of CAUTI in patients that have had indwelling bladder catheters placed in ED.  

History:

  • in 2017, 5 CAUTI linked to ED placed catheters
  • in 2018 implemented 2 RN cath placement, bladder scanning prior to placement and strick indications for placement
  • in 2019, 2 CAUTI  linked to ED placed catheters
  • in 2020, 4 CAUTI  linked to ED placed catheters (presumably linked to national trend, see article from CDC https://www.cdc.gov/hai/data/portal/covid-impact-hai.html
  • Plan: include unlicensed staff for CAUTI prevention and proper care principals (see https://www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/education-bundles/indwelling-urinary-catheter-use/catheter-care/slides.html ) include keep bag empty, no kinks, below bladder…
  • Proposed Education solution:
    • Competency based education of  proper care principals for unlicensed staff (e.g. transporters, EMTs, etc).
    • Set up 5 simulation rooms with proper and improper catheter use (e.g. kinked tubes, bags on patient stomachs, bags on floor, bags too full, etc)
    • Have staff ID correct and incorrect rooms and what actions are needed for improper cath use.
    • Outcomes measured by continued CAUTI surveillance systems.
    • Cost/benefit analysis:
    • Educator time to validate staff (three 8-hour days 24 hours x $60/h = $1560 )
    • Simulation rooms (will use 5 vacant patient rooms of a closed down unit, cost $0)
    • 5 catheter and bag kits (5x 2$8 ea= $40)
    • Unlicensed staff time (20 staff @ ~$30/hr x 0.5 hours= 300)
    • Total estimated cost= $1900
    • Est. cost of CAUTI =  $13,793/patient     [https://www.ahrq.gov/hai/pfp/haccost2017-results.html]
    • therefore: 7.2x savings return on investment for each CAUTI prevented ($13,793/$1900)
    • Stakeholders:
    • ED managers
    • Non-licensed staff
    • patients