CAUTIs in Critical Care
- 0Jan 15 by silverbelleMy hospital is trying to reduce Critical Care Cather Associated UTIs. We are doing better but still have more than our goal. We are told that hospitals across the country have 0 in a year. I simply don't see how this is possible. If a patient is on a vent, sedated, incontinent and has multiple infectious processes going on.... how is it possible to keep them from getting a UTI? Very frustrated, we are trying but just not getting where we want to go....
What do these hospital do...do they not use Foleys in anybody???
- 0Jan 15 by Nalon1 RN/EMT-PI don't know the exact number at my facility, but I heard we had like 4 CAUTI's last year (mid size suburban hospital, ~ 110 floor beds plus surgical and L&D beds)
We have mandatory annual training on foley insertion for all nurses, minimal twice daily foley care and strict guidelines for both putting them in and when they come out. Surgical patients have 2 day maximum unless the order is renewed. Generally if a patient can walk, foley should come out. Conscious males rarely have them.
- 0Jan 22 by Here.I.StandFewer foleys--discretion with who really needs strict I&O, condom caths for males who don't have obstructions; incontinence isn't a rationale for having one
TID foley care. We use barrier cream wipes for stool incontinence but have begun keeping them away from the urinary meatus, since the oily substance can trap bacteria
Dual insertion for every single Foley. The second RN can help hold skin on females and verify that sterile technique is maintained
Adhesive anchoring device, vs. the elastic Velcro leg band
UCs only if pt is symptomatic of a UTI (subjective sx or VS changes). They can't come back positive if they're not done, and if the pt is not symptomatic they don't need to be treated. We treat infections, not colonizations.
Daily chlorhexidine washes
Simple stuff like always emptying the bag before repositioning to the other side of the bed, rinsing the graduate after emptying, changing the graduate weekly