Staff Nurse Peer Feedback: Urinary Catheter Management
Heather Laplume BSN, RN, BC, Barbara Pashnik BSN, RN, CIC, CDOE, Gloria Ribeiro BSN, RN,BC BC, Michelle Finkelman BSN, RN BC, CCRN, Michelle Ehlinger BSN, RN BC
Purpose: The initiative is to strive for zero harm for by implementing new strategies for standardizing the practice of insertion and care and maintenance of urinary catheters by using a staff nurse champion model with strong emphasis on the value of peer feedback. Relevance/Significance: Inconsistent practice with insertion, care and maintenance of urinary catheters can lead to catheter associated urinary tract infections (CAUTI) and have a significant negative impact on morbidity, mortality, hospital costs, and length of stay. Despite multiple recent interventions, CAUTI standardized infection ratios (SIR) remain higher than the national benchmark. Strategy and Implementation: A team of nurse champions and an Infection Preventionist aimed to educate all nursing staff regarding adherence to CAUTI bundle requirements. Several interventions were implemented as part of this education. The first intervention included competency verification of catheter insertion, sample collection and care and maintenance. A second intervention included auditing of a two-person insertion process. The final intervention was a weekly bundle audit of all patients with urinary catheters using “just in time” feedback. Evaluation: This represents a 48% reduction in CAUTIs since the implementation in 2015. Implications: This initiative encourages standardization for urinary catheter practices while increasing nursing autonomy, patient advocacy, and improved communication and collaboration.
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