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www.ahrq.gov/sites/default/files/wysiwyg/hai/cauti-tools/cauti-icu/preventing-cauti-icu-setting-module-1-slides.pptx
September 01, 2015 - values, attitudes, or beliefs (i.e., “behavior based”)
Examples:
Are nurses reluctant to remove urinary catheters … CAUTI in Hospitals
16
Methods for Mitigating Risk
Optimize insertion practices
Prevent insertion of catheters … when patient's case does not meet one of HICPAC's approved indications
Promote aseptic insertion by … Perform clinical assessment for signs/symptoms of UTI
Increase use of alternatives to indwelling urinary catheters … Condom catheters (evaluate multiple products)
Moisture-wicking incontinence pads
Bladder scanners
Intermittent
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www.ahrq.gov/hai/clabsi-tools/appendix-2.html
March 01, 2018 - Use full-barrier precautions during CVC insertion
Bottom line: Maintain aseptic technique for the … insertion of intravascular catheters. … The pathogenesis and epidemiology of catheter-related infection with pulmonary artery Swan-Ganz catheters … Central venous catheter-related infection in a prospective and observational study of 2,595 catheters … Risk of infection due to central venous catheters: effect of site of placement and catheter type.
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www.ahrq.gov/sites/default/files/publications/files/ena-slides.pdf
September 01, 2015 - .............................................................................................. 16
Aseptic … Up to 25 percent of admitted patients have urinary
catheters placed. … • Finally, catheters are uncomfortable and the resulting urinary tract infections even more so. … AHRQ Safety Program for Reducing CAUTI in Hospitals Transcript 18
Aseptic Technique Survey … Removal Survey
Obstacles to Change
Aseptic Technique Survey
Two-Person Survey
Training and Observation
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/guides/ena-slides.pdf
September 01, 2015 - .............................................................................................. 16
Aseptic … Up to 25 percent of admitted patients have urinary
catheters placed. … • Finally, catheters are uncomfortable and the resulting urinary tract infections even more so. … AHRQ Safety Program for Reducing CAUTI in Hospitals Transcript 18
Aseptic Technique Survey … Removal Survey
Obstacles to Change
Aseptic Technique Survey
Two-Person Survey
Training and Observation
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www.ahrq.gov/hai/cauti-tools/phys-championsgd/section8.html
October 01, 2015 - Resident Physician Device Risk Checklist
Device
Action Taken (if necessary)
Urinary Catheter … a
Yes
No
Catheter secured?
Yes
No
Bag below bladder? … Yes
No
Peripheral Venous Catheter (PVC)
Dressing intact? … Yes
No
Central Venous Catheter (CVC)
Dressing intact? … b
Yes
No
a The appropriate indications for urinary catheter include: urinary flow obstruction
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www.ahrq.gov/hai/cauti-tools/archived-webinars/preventing-cauti-plan-b-slides.html
December 01, 2017 - Placement
Maintaining Awareness & Proper Care of Catheters
Prompting Catheter Removal
Preventing … Placement
Maintaining Awareness & Proper Care of Catheters
Prompting Catheter Removal
Preventing … Placement
Maintaining Awareness & Proper Care of Catheters
Prompting Catheter Removal
Preventing … Placement
Maintaining Awareness & Proper Care of Catheters
Prompting Catheter Removal
Preventing … review or “deeper dive” to identify improvement opportunities
Ensuring competency in insertion using aseptic
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www.ahrq.gov/hai/cauti-tools/facil-guide/preventing-cauti-icu-setting-module2-speaker-notes.html
February 01, 2023 - Module 2: Urinary Catheter Maintenance Facilitator Notes
Preventing CAUTI in the ICU Setting … The nurse also notices that the patient’s urinary catheter isn’t secured to her leg. … Not attaching the catheter to the leg can lead to urethral irritation. … Well, how we handle the catheter tubing and bag can make a big difference.” … Next, the nurse empties the urinary catheter bag.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/icu-assessment-guide.pdf
April 01, 2022 - Are staff in your unit aware of alternatives to indwelling urinary catheters? … Kits are designed to drive aseptic, safe
insertions, and without them, significant variation often occurs … Insertion Bundle
o Ensuring Aseptic Placement
http://www.ahrq.gov/hai/tools/clabsi-cauti-icu/implement … Donovan – How To Empower Staff To Speak Up To
Stop a Central Line Insertion if They See a Breach in Aseptic … Guideline for prevention of catheter-associated
urinary tract infections 2009.
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www.ahrq.gov/sites/default/files/publications/files/clabsineonatal.pdf
October 01, 2012 - -Define consistent practice to be used when
accessing catheters
2. … Assemble and connect infusion tubing
using aseptic or sterile technique. … -Aseptic technique includes clean barrier for
6
tubing assembly and wearing of clean gloves … (PICC), umbilical artery
catheter (UAC), umbilical venous catheter (UVC), Broviac (a surgically placed … Types of catheters in use among patients with infections*
Catheter Type N (%)
PICC 84 (50.6)
UVC
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www.ahrq.gov/sites/default/files/wysiwyg/hai/cauti-tools/cauti-icu/preventing-cauti-icu-setting-module_2-speaker-notes.docx
September 01, 2015 - The nurse also notices that the patient’s urinary catheter isn’t secured to her leg. … The nurse failed to use a securement device to attach the catheter to the patient’s leg. … Not attaching the catheter to the leg can lead to urethral irritation.
3. … Well, how we handle the catheter tubing and bag can make a big difference.” … Next, the nurse empties the urinary catheter bag.
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www.ahrq.gov/hai/cauti-tools/cauti-icu/facil-guide/mod2.html
February 01, 2023 - Preventing CAUTI in the ICU Setting: Facilitator’s Guide
Module 2: Urinary Catheter Maintenance … Not attaching the catheter to the leg can lead to urethral irritation. … Well, how we handle the catheter tubing and bag can make a big difference.” … Next, the nurse empties the urinary catheter bag. … What should be done with the urinary catheter bag?
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www.ahrq.gov/hai/cauti-tools/phys-championsgd/section5.html
October 01, 2015 - senior RP makes sure all RPs involved in placing CVCs adhere to complete barrier precautions, ensuring aseptic … examples include evaluations of compliance with infection risk reduction strategies (e.g., use of low-risk catheters … Maintenance of venous catheters: CVCs and PVCs are accessed multiple times daily. … The intravenous therapy team may help identify areas for improvement related to venous catheters and
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psnet.ahrq.gov/web-mm/breakage-picc-line
June 21, 2023 - Only two catheters fractured less than 2 months after insertion. … All catheters were fractured at or near the entrance site. … Placement and management of long-term venous access catheters and ports. … Complications of vascular catheters in the neonatal intensive care unit. … aseptic precautions for insertion and maintenance of the catheter, including dressing changes, tubing
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psnet.ahrq.gov/web-mm/hyponatremia-secondary-home-parenteral-nutrition-error
May 27, 2020 - gastroschisis and subsequent volvulus in infancy resulting in short bowel syndrome, central venous catheter … A tunneled, single lumen, cuffed central venous catheter is the recommended central venous catheter for … children with intestinal failure who require long-term home PN. 12 Children with central venous catheters … , aseptic technique for central venous catheter dressing changes, and cleansing of the hub of the central … venous catheter with antiseptic solution prior to flushing or administering PN. 12 Pediatric intestinal
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/implementation-guide.pdf
April 01, 2022 - techniques
o Central Venous Catheter Maintenance – maintaining awareness and proper care
of catheters … in place
o Central Venous Catheter Removal – prompting removal of unnecessary
catheters
• CAUTI … Alternative to Indwelling Urinary Catheters – review when alternatives to
indwelling urinary catheters … are appropriate in the ICU setting
o Indwelling Urinary Catheter Insertion Bundle – ensuring aseptic … placement
o Indwelling Urinary Catheter Maintenance – maintaining awareness and proper
care of catheters
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/guide.html
March 01, 2017 - Many of these catheters are placed without indications. … insertion and maintenance of catheters. … Aseptic Insertion
Insert new urinary catheters only when there is a good indication for it. … urinary catheters and, if possible, have a two-person team to observe and support aseptic technique. … Using suprapubic, in/out, or penile condom catheters, if possible.
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www.ahrq.gov/hai/cauti-tools/archived-webinars/sustaining-change-transcript.html
December 01, 2017 - B's urinary catheter? They changed it to an antimicrobial catheter. … There's not data for antimicrobial catheters. … When it's placed, it's placed in a sterile aseptic manner and maintained properly. … We're confident in their aseptic technique. All, none, some, or one. Let's look at the answers. … We have condom catheters. We have appropriate skin care.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/sustaining-change-transcript.docx
April 14, 2015 - B's urinary catheter? They changed it to an antimicrobial catheter. … There's not data for antimicrobial catheters. … When it's placed, it's placed in a sterile aseptic manner and maintained properly. … We're confident in their aseptic technique. All, none, some, or one. Let's look at the answers. … We have condom catheters. We have appropriate skin care.
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www.ahrq.gov/hai/cauti-tools/archived-webinars/preventing-cauti-specialized-populations-icu-slides.html
December 01, 2017 - Slide 8
Case
Image: Diagram showing the causes of urinary catheter harm. … Slide 28
Education – Direct the Rider
HICPAC guidelines:
Appropriate
Inappropriate
Aseptic … it, plus images of catheter alternatives. … monitoring UOP”
They are “sick” and we need to know “ins and outs” every hour
The need for urinary catheters … Alternatives
Began to reinforce use of catheter alternatives such as the condom catheter:
Educate
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www.ahrq.gov/hai/cauti-tools/archived-webinars/integrating-teamwork-tools-cusp-efforts-transcript.html
December 01, 2017 - placed or should not have a catheter placed. … we focus a lot of our attention is on promoting proper insertion techniques, primarily, sterile or aseptic … Avoiding unnecessary catheter utilization in the ED. … Failure to clarify who owns responsibility for continuing to leave catheters in patients. … Express concerns about unneeded catheter insertion or retention.