A multidisciplinary project at NYC Health + Hospitals/Coney Island that significantly reduced catheter-related urinary tract infections has been selected for presentation at the National Patient Safety Foundation’s Annual Patient Safety Congress.
Dr. Kanchan Gupta, director of the Hospitalist Division and the Patient Safety Officer at NYC Health + Hospitals/Coney Island, will be presenting the work at the Congress.
Catheter-associated urinary tract infections (CAUTI) are a major cause of infections in hospitals. Using a team approach, NYC Health + Hospitals/Coney Island was able to significantly reduce infections due to catheter use over the last 18 months.
“It was a team effort,” Dr. Gupta says. “Not just doctors, but nurses, doctors, nursing associates, infection control nurses and unit clerical staff. People work better in teams. Everyone is looking out for each other.”
The team used a multi-pronged effort to combat infections, Dr. Gupta says. First, the team took a hard look at the use of catheters and encouraged physicians to first consider noninvasive methodologies. “If we have fewer insertions, we have less chance of infections,” he says. The team then required attending physicians to examine patients with catheters on a daily basis to determine whether a catheter was still needed. In addition, training sessions were held on the proper way to use catheters. Guidelines for insertion and maintenance were reviewed.
Finally, when an infection did occur, the team did a “mini-root cause analysis” at the bedside to see what went wrong. “We wanted to see in real time where the slippage had occurred,” Dr. Gupta says, “and the lessons learned were shared throughout the organization so that the same mistakes did not occur in other units.”
The results were dramatic. The average rate of catheter-related urinary tract infections in the hospital dropped from 11.86, when the program began in 2014, to an average of 2.61 as of August, 2015. And for the calendar year 2015, the rate was only 1.49.
“During this period, for three months we had infection rates,” Dr. Gupta says. “We also decreased the number of days patients had catheters and we were very aggressive about taking out catheters when they were no longer needed. There was a 15 percent reduction in the number of catheters days.”