Tray Helps Hospital Reduce Risk

Data suggest that use of Medline Industries Inc.'s ERASE CAUTI program has helped Unity Hospital (Rochester, NY) reduce the risk of catheter-associated urinary tract infections. The program features a one-layer catheter tray along with education and training.

The ERASE CAUTI program was rolled out to all acute care units at Unity Hospital in August 2010. According to data from the 340-bed, nonprofit hospital, the facility reduced its urine Nosocomial Infection Markers (NIMs) 32% in August 2010, compared with the same time period in 2009. The associated cost for each urine NIM marker is $3,637, which demonstrates a significant cost-avoidance following the introduction of the ERASE CAUTI program, according to Unity Hospital. Urine NIMs are an electronic marker that uses sophisticated algorithms to analyze existing microbiology laboratory and patient census data to identify hospital-acquired infections.

"Although we had a low CAUTI rate in 2009, after implementing the ERASE CAUTI program rates continue to trend downward," said Erica Perez, Unity's clinical educator, in a press release issued by Medline Industries. "The program ties in education, nursing power, and a new industry product that promotes best processes by reinforcing the CDC guidelines to decrease the opportunity for a CAUTI to develop."

Perez reported that the hospital began using the ERASE CAUTI program because it identified gaps in standardization and knowledge regarding the proper insertion technique and clinical indications for using a Foley catheter. "This initiative is intended to ensure standardized nursing practice across all clinical areas, which we know will lead to better patient outcomes," said Perez.

"The Medline program offered the tools to reduce the inconsistencies we observed in the technique nurses used to insert catheters due to differing protocols at previous facilities where nurses have practiced, variance in how nurses were initially taught the procedure and different types of Foley trays nurses have used in the past," said Perez.

Perez emphasized that Medline's one-layer tray presents the procedure components intuitively, guiding nurses through the procedure from left to right. The tray also makes it easier to maintain aseptic technique because all the components are in one tray instead of the traditional two layers.

The checklist on the Foley tray's outer package also helps nurses follow recommended insertion guidelines from the Centers for Disease Control and Prevention (CDC), Perez reported. A second checklist also helps the nurses identify the clinical indications for catheterization. The checklists are printed on a peel-off sticker to fit in the patient chart or medical record.

The program features online education to reinforce aseptic technique through learning modules and an interactive competency tool clinicians use to demonstrate knowledge of proper Foley insertion technique. To date, more than 500 nurses have completed the education classes via Medline's e-learning site Medline University. These online modules have been added to the hospital's clinical orientation as a mandatory core competency for new nursing staff.

To educate patients, Medline's new tray contains a Patient Care Card intended to look like a "Get Well" greeting card with key educational elements scripted for the clinician to review at the bedside with the patient and family.

"The implementation of the ERASE CAUTI program has helped us to improve the standard of care for patients receiving a Foley catheter and has reduced the risk of CAUTI," said Perez. "The reduction in urine NIMs indicates fewer patients may be at risk for developing a CAUTI."

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