presented by Kathleen Vollman
Catheter-associated urinary tract infections (CAUTIs) are the only device-related infections which have increased in the last five years. National quality and safety initiatives as well as reimbursement strategies are targeted to focus on reducing CAUTIs. This course will review the evidence within the existing guidelines for management and early removal of the catheter or preventing placement altogether. In addition, we will explore innovative process and product technology that will help to reduce or eliminate CAUTIs. This course content is applicable to nurses and other health care professionals who work with patients in acute care, rehabilitation, and long-term care facilities.
Kathleen Vollman is a Critical Care Clinical Nurse Specialist, Educator, and Consultant. She has published and lectured nationally and internationally on a variety of topics, including pulmonary care, critical care, prevention of health-care-acquired injuries, work culture, and sepsis recognition and management. From 1989 to 2003, she functioned in the role of Clinical Nurse Specialist for the Medical ICUs at Henry Ford Hospital in Detroit Michigan. Currently her company, ADVANCING NURSING LLC, is focused on creating empowered work environments for nurses through the acquisition of greater skills and knowledge. Ms. Vollman is a subject matter expert for prevention of CAUTI, CLABSI, and HAPI as well as sepsis recognition/management and the culture of safety for HRET and the Michigan Hospital Association. In 2004, Kathleen was inducted into the College of Critical Care Medicine; in 2009, she was inducted into the American Academy of Nurses. In 2012, Ms. Vollman was appointed to serve as an honorary ambassador to the World Federation of Critical Care Nurses.
Twelve to sixteen percent of adult inpatients will have a urinary catheter at some time during their hospital stay. CAUTI complications can cause discomfort for the patient, increase hospital length of stay and health care costs, and impact mortality. This session addresses the magnitude of the problem, the risk factors for development, and how CAUTIs fit into the current reimbursement structure.
Assessment of need for a catheter should be based on criteria that are clearly defined. It is challenging to break through routine practices for catheter placement in ERs, ORs, and ICUs that have existed for years. This chapter will examine the process around the decision to insert a catheter, the use of alternatives, and the procedure for insertion.
Maintaining the catheter using evidence-based practices includes: care of the catheter during bathing and fecal incontinence episodes, culturing practices, and nurse-driven early catheter removal programs. When practiced together in a robust safety culture, these maintenance interventions can significantly reduce CAUTIs.
The last CAUTI prevention national published guidelines from the CDC occurred in 2009, and the infectious disease and hospital epidemiologist as well as the infection preventionist groups latest updates occurred in 2014. The creation of new evidence and technology is evolving at a rapid pace, and this chapter will outline all the latest innovations that go beyond the guidelines.