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Bringing a standards of practice lens to minimize Catheter Acquired Urinary Tract Infection (CAUTI) in… Crosby, Lisa; Mok, Carmen 2014

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Bringing a Standards of Practice Lens to Minimize Catheter Acquired Urinary Tract Infection (CAUTI)  In Vancouver Coastal Health By: Lisa Crosby and Carmen Mok UBC SoN 2014 Background Abstract: The goal of this project was to enhance the application of Best-practice guidelines and the CRNBC Standards of Practice (assessment, documentation, communication, and advocacy) to reduce the incidence of CAUTI. We conducted a literature search to explore available resources, and we found extensive research on Best-practice guidelines for CAUTI, but there was a lack of existing evidence that explored the relationship between the Standards and CAUTI reduction. The main outcome of our project, was the development of a storyboard that will be converted to an online Course Catalogue Registration Module (CCRS) module. The storyboard provides the user with the opportunity to work through a patient case scenario, applying both Best-practice and the Standards when learning about CAUTI reduction.  Literature Review- CRNBC Library  q??There is a lack of existing evidence that examines practice standards in relation to CAUTI reduction or Healthcare-acquired infections in general q??We decided to use a case study model to encourage critical thinking about the application of Standards into a patient scenario Literature Review Findings We gathered the most recent Best-Practice Evidence related to CAUTI reduction: ?? CINAHL, Pubmed, and Dynamed ?? VCH Resources and Documents:  Urinary Catheter Insertion Checklist, VCH algorithm- Management of CAUTI in Adult-Nursing, VCH CAUTI Education Module.............  Action Checklist We integrated the clinical best practice guidelines and the CRNBC Standards of Practice with the action checklist for our education module: The action checklist provides a framework for thinking about the multiple intervention points (the 4 ?buckets?) where applying Best-Practice guidelines and CRNBC Standards of Practice with a focus on assessment, communication, documentation and advocacy:  1) Conducting a thorough assessment to determine the necessity for an indwelling urinary catheter 2) Using aseptic technique for catheter insertion, and completing the appropriate documentation that allows for continuity of care,  which facilitates effective communication 3) Using best practice evidence and hospital policy guidelines for care and management of the indwelling catheter, as well as promoting advocacy through providing  patient education and engagement   4) Review the necessity for the indwelling catheter on a daily basis, and initiate removal as soon as indicated  CRNBC Reflective Questions  We tailored the reflective questions, based on the CRNBC Professional Standards to the patient scenario, specifically regarding practices to reduce CAUTI. We used these reflective questions to help promote assessment, documentation, communication, and advocacy in practice, with the goal of ultimately reducing CAUTI.  How do I show accountability for my decisions and actions regarding catheterization? How do I maintain or promote continuity of client care in patients with indwelling catheters? What assessments are required to avoid unnecessary urinary catheters? How do I ensure my clients have the information required  to make informed decisions? Are they properly informed to the need for an indwelling catheter? Education Module Objectives: ?? Increase knowledge of CRNBC Standards and how they relate to CAUTI prevention  ?? Enhance the understanding and application of the importance of assessment, documentation, communication and advocacy in mitigating the incidence of CAUTI ?? Improve daily follow-up of client care related to catheter insertion, care, maintenance and removal ?? Promote use of correct technique for insertion maintenance and removal of a urinary catheter  Process and Highlights We developed a storyboard for an interactive education module, using a case study and associated case-based questions. In the scenario, a client transitions from the ER to the medical unit with an indwelling catheter. Standards of practice and clinical best-practice considerations were inputted to involve the participant, challenging them  to critically think of what their actions and considerations would be if they were the care-provider displayed in the scenario. Pre and post test questions, CAUTI facts and statistics, links to hand hygiene, and reminders about aseptic technique were threaded throughout the course to engage participants effectively and evoke critical thinking.  For more information: please keep on the look out for the CCRS module.  In partnership with Prab Gill | RN, BSN, MSN Acting Director, Professional Practice - Nursing, Vancouver Vancouver Coastal Health Adjunct Professor, UBC School Of Nursing  Anne Logie, RN, MA Nursing Practice Advisor: Vancouver North Policy, Practice and Quality Assurance College of Registered Nurses of British Columbia   Cathy Cotter, RN, BScN Nursing Practice Advisor: Vancouver South, Richmond Policy, Practice and Quality Assurance College of Registered Nurses of British Columbia   References College of Registered Nurses of British Columbia. (2012). Professional Standards for Registered Nurses and Nurse Practitioners. Retrieved from https://crnbc.ca/Standards/Lists/StandardResources/128ProfessionalStandards.pdf.  College of Registered Nurses of British Columbia. (2012, November). Reflective Questions Poster: How do you meet the CRNBC Professional Standards? Retrieved from : https://crnbc.ca/PracticeSupport/Documents/13w1Reflectivequestionsposter.pdf  Vancouver Coastal Health: Professional Practice (2012). Preventing CAUTIs Action Checklist - VCH  Vancouver Coastal Health. (2013, July) VCH Algorithm - Management of Catheter Associated Urinary Tract Infections (UTI) in               Adult Nursing (Draft).   Vancouver Coastal Health. Indwelling Urinary Catheter (IUC) Removal Algorithm.   Vancouver Coastal Health. Urinary Catheter Insertion Checklist.   Vancouver Coastal Health (2013, July). Indwelling Urethral Catheter:  Care and Management (Short term) - Adult.      

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