using nhsn definitions for surveillance: urinary tract infection (uti) stanley ostrawski, ms, rn,...
TRANSCRIPT
Using NHSN Definitions for Surveillance: Urinary Tract Infection (UTI)
STANLEY OSTRAWSKI, MS, RN, MT(ASCP), CICInfection Preventionist Consultant
Objectives• Explain how to calculate a CAUTI rate• Explain how to complete NHSN UTI forms using CDC
definitions and protocols• Apply case definitions of Urinary Catheter-
associated infections to case studies
Introduction – Urinary Tract Infections and Indwelling Urinary Catheters
• The urinary tract is the most common site of HAI
• Almost all UTIs are directly related to catheterization of the urinary tract
• CAUTI can lead to complications such as pyelonephritis or bacteremia,
CAUTI –Terms and Definitions
Use CDC Definitions for the following: – CAUTI– Indwelling catheter– SUTI– ABUTI– OUTI
Definition: CAUTI
CAUTI is a urinary tract infection (UTI) that occurs in a patient who had an indwelling urinary catheter in place within the 48-hour period before the onset of the UTI
NOTE: There is no minimum period of time that the catheter must be in
place in order for the UTI to be considered catheter-associated
Definition: Indwelling Catheter
• A drainage tube that is inserted into the urinary bladder through the urethra, is left in place, and is connected to a closed collection system.– Also called a Foley catheter– Does not include straight in and
out catheters– Does not include suprapubic or
nephrostomy catheters
Rm #
Name Age
Diagnosis Catheter IV Resp
PICU - Monday, October 31, 2011 1:00 PM
106 Brandon Smith 6 Influenza PICC IPPB q 6 hr
107 Nicole Brown 18 mos.
PneumoniaOtitis Media
CVC – Femoral
108 Aamina Bidouk 3 Status epilepticus Foley to dd Swan ganzPICC
Tracheostomy, ventilator
109 Robin White 6 Viral meningitis PIV X 2
110 David Cranshaw 10 Asthmatic bronchitis
PIV right antecubCVC Jugular
Ventilator – weaning off
111 Susanna Solomon 7 mos RSV pneumonia Cath for spec.
PIV right antecub IPPB q 6 hr
112 Davey Blue 4 Pneumonia CVC – Subclavian Vent cont.
113 Amy O’Donnell – transferred to Surgical Peds Ward at 11AM
6 Repair – congenital heart defect
Foley out @ 10:30AM
PICC Vent . Extubated at 10:30 am – on room air
114 Brie Bennett 2 Anaphalaxis to bee sting
Foley to dd Swan ganzCVC subclavian
Vent cont.
115 Harrison Black – admitted from ED @ 9 am
14 mos
RSV pneumonia/congenital heart disease
PICC Intubated in ED– on vent cont.
2
Specimen CollectionUrine specimens for culture should be processed as soon as possible, preferably within 1 to 2 hours. If urine specimens cannot be processed within 30 minutes of collection, they should be refrigerated, or inoculated into primary isolation medium before transport, or transported in an appropriate urine preservative. Refrigerated specimens should be cultured within 24 hours.
Calculating the CAUTI Rate
*Stratify by location type – • ICU or other location
2009 NHSN Report
Edwards JR, et al. Am J Infect Control 2009;37:783-805
2011 NHSN Report
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Turning Data into Knowledge
Have a plan to share the data with those individuals who can make a difference:• Nursing Staff• Medical staff• Administration• Board of Directors• Performance Improvement department• Patient safety leaders
Questions?