Year of Publication

2015

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Melanie G. Hardin-Pierce

Clinical Mentor

Dr. Zim T. C. Okoli

Committee Member

Dr. Darlene Welsh

Abstract

Background: There are more than 1 million Catheter Associated Urinary Tract Infection (CAUTI) occurrences per year in the United States, with an estimated cost to treat of $400 million dollars annually (Clarke et al., 2013). Urinary Tract Infections are the most common hospital acquired infection, comprising roughly 30 - 40% of all infections occurring in acute care hospitals (Gould et al., 2009). In February of 2013, the University of Kentucky (UK) Hospital made drastic changes to the current Catheter Associated Urinary Tract Infection (CAUTI) prevention standards by instituting a CAUTI Maintenance Bundle to prevent the incidence of CAUTIs.

Purpose: To evaluate the adherence to a Catheter Associated Urinary Tract Infection Maintenance Bundle (CAUTI bundle) at the Trauma Intensive Care Unit (TICU) of the University of Kentucky Hospital.

Methods: To perform a retrospective adherence evaluation of a CAUTI bundle. Objectives include: (1) describe adherence to practice guidelines of a CAUTI bundle in TICU through the examination of de-identified data one year after bundle implementation (data was obtained from the records of patients hospitalized during a twelve-month period - May 2013 through May 2014); and, 2) examine the associations between adherence to practice guidelines of a CAUTI bundle and specific patient characteristics (age, gender, race, body mass index, and hospital length of stay). De-identified electronic medical record data was used to evaluate staff adherence to a CAUTI bundle during a twelve-month period.

Results: The results described daily adherence to CAUTI bundle guidelines and specific criteria. The results also described associations between daily adherence to practice guidelines and patient variables.

Conclusion: By evaluating the adherence to a CAUTI bundle, potential barriers to adherence were identified. Nurses play a key role in the CAUTI bundle implementation process in that the responsibility of insertions, maintenance, and care rests on the nursing staff. An evaluation to the adherence of this CAUTI Bundle was critical in identifying potential barriers of adherence and improving indwelling catheter care practice.

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