Insertion,RemovalandCareofanIndwellingFoleyCatheter.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RESULTS – Documentation and Surveillance Current Practice Survey How is urinary output and catheter care management documented on your primary unit? N=75 Which of the following aspects of urinary output and catheter care management are routinely documented on your primary unit? % N=75 CDC Documentation Recommendations Consider documenting the following: indication, date and time of insertion, who inserted, date and time of removal (Category II) Ensure that documentation is accessible and in standard format. Searchable electronic documentation is preferable. (Category II) Does your hospital have a system to remind providers to remove indwelling catheters? Nurse driven protocol to discontinue (40%) Paper reminders (36%) Electronic reminders (37%) Nurse led catheter rounds (35%) Other Stickers on MD orders and medical records ICUs have prompt on daily goal sheet Electronic Stop Orders N=75 Recommended strategies for reducing catheter use and duration (Category 1B) System of alerts or reminders Guidelines and protocols for nurse-directed removal Education and performance feedback Guidelines for perioperative use Protocols for management of postoperative urinary retention Do your infection practitioners perform routine surveillance for CAUTIs? Where is surveillance conducted? House-wide (64%) ICU only (13%) Did not answer or did not know (13%) NA (9%) Catheter days are collected All units (51%) Selected units (35%) Not done (14%) N=75 CDC Surveillance Recommendations Consider surveillance for CAUTI when indicated by facility-based risk assessment. (Category II) Use standardized methodology for performing CAUTI surveillance (includes measures of catheter-days) (Category 1B) Routine screening of catheterized patients for asymptomatic bacteriuria is not recommended (Category II) Consider providing regular feedback of unit-specific CAUTI rates to nursing staff. (Category II) Summary NICHE hospitals are imple