Reducing Catheter-Associated Urinary Tract Infections in the Pediatric Intensive Care Unit

Problem: CAUTIs (catheter-associated urinary tract infections) are a common hospital-acquired condition (HAC) that increase length of hospital stays, hospital costs, and risk for patient mortality. CAUTI rates in a PICU increased in 2021 from the year 2020. A rapid cycle PDSA revealed nurses were not using soap and water for foley catheter care, which is the recommended cleanser by the Centers for Disease Control and Prevention (CDC). Methods: An observational descriptive design was used to evaluate foley catheter cleaning and CAUTI rates. PICU nurses completed behavior surveys regarding foley catheter cleaning practices. An education intervention occurred when nurses answered anything other than “soap and water” to the question, “what was used for foley care?” CAUTI rates and average foley days were obtained from a patient safety and quality improvement specialist at the hospital. Results: PICU nurses reported 100% (n=62) compliance to use of soap and water for foley catheter care in PDSA cycle three, compared to 8.8% (n=10) using soap and water In PDSA cycle one, and 97.2% (n=106) in cycle two. Zero CAUTIs occurred from April 2021 to April of 2022. Limitations to the study include a small sample size, short study period and a potential limitation was nurses self-reported. Implications for practice: The study results demonstrate the benefits of targeted nurse rounds and education for increasing bundle compliance. Decreased CAUTI rates cannot be directly correlated to an increase in foley catheter care compliance due to self-reported data