Division of Disease Control and Health Protection

Catheter-Associated Urinary Tract Infection (CAUTI)

Prevention Collaborative

The CAUTI collaborative began its initial cohort in September 2010 with 17 acute care facilities and is currently planning for a second cohort to begin in the fall of 2011. The collaborative consists of two phases: the first phase focuses on surveillance, data collection, and establishing baseline measurements for CAUTI in participating facilities. The second phase involves implementation of evidence-based prevention strategies for CAUTI. Participating facilities use the National Healthcare Safety Network (NHSN) as a means of reporting data for collaborative participation. 

The FDOH healthcare-associated infection preventionists and epidemiologists are working with collaborative participants to Stop CAUTI.  Participants will be provided:

• guidance and assistance on data collection, analysis, and validation;
• training on case definitions and prevention strategies;
• data validation;
• opportunities to collaborate with peers on successes and opportunities for improvement during monthly conference calls; and
• guidance on the implementation of prevention strategies.

These services are provided by FDOH staff and/or through partnerships and vendor contracts.  FDOH staff conducts site visits to review findings from the pre-assessment and identify action steps to implement surveillance and prevention.

Participating healthcare facilities will be asked to designate a unit or multiple units within their facility to focus on CAUTI reduction.  Participants are required to:

• demonstrate senior leadership (C-Suite) support by signing a letter of commitment;
• complete a pre-assessment tool;
• implement evidence-based prevention strategies for CAUTI;
• review progress monthly with team members and staff;
• Submit monthly CAUTI data through NHSN by the 25^th of the following month; and
• Participate in site visits, training, and monthly collaboration calls with FDOH staff.

Additionally, participating facilities are required to establish and maintain multidisciplinary and unit teams to facilitate the implementation of evidence based prevention strategies.  The multidisciplinary team includes (at a minimum) a senior management leader, clinical champion (R.N. or M.D.), and an infection preventionist or quality lead.  Each unit team consists of, at a minimum, a team leader/nurse manager, staff nurse, and patient technician.  At least one team member is designated as the person responsible for ensuring appropriate data collection for the specified unit.  

Terminal Objectives

The terminal objectives for the hospitals participating in the collaborative are, by December 31, 2012, to:

Acute Care/Long-term Acute Care

1. Reduce CAUTI per 1,000 urinary catheter days by 25% from baseline or to zero.

2. Reduce device utilization (urinary catheter days / patient days x 100) by 50%.

CAUTI Evidence-Based Prevention Strategies For Collaborative

1.     Insert catheters only for appropriate indications.

2.     Remove unnecessary catheters.

3.     Perform hand hygiene in compliance with CDC or WHO.

4.     Provide education on proper insertion and maintenance.

5.     Limit insertion of catheters to trained personnel.

6.     Insert catheters using aseptic technique and sterile equipment.

7.     Properly secure indwelling catheters after insertion to prevent movement and urethral traction.

8.     Maintain closed drainage system.

9.     Maintain unobstructed urine flow.

10.  Cleaning the metal area with antiseptic solutions in unnecessary; routine hygiene is appropriate.

11. Remove catheter within 48 hours following surgical procedure or document reason for extended use.

12. Implement and promote alternatives to indwelling urinary catheterization.

For more detailed information on these strategies go to http://www.cdc.gov/hicpac/cauti/002_cauti_sumORecom.html.

Supporting Documents and Resources

CAUTI Timeline Cohort 2

CAUTI Tools and Activities Cohort 2

FDOH NHSN User Group Data Use Agreement 
Introduction to the FDOH HAI Prevention Collaboratives: Fall 2011

National Healthcare Safety Network (NHSN) Resources

Cohort 2 Required Forms and Tools - Hospital/LTACH

CAUTI Cohort 2 Hospital Commitment Form
CAUTI Cohort 2 Hospital Preassessment

Cohort 2 Required Forms and Tools - Nursing Homes/SNF

CAUTI Data Collection Form SNF-NH

CAUTI Cohort 2 SNF-NH Commitment Form

Cohort 2 Nursing Home/SNF Preassessment

Optional CAUTI Tools

Catheter Insertion Checklist

Catheter Removal Algorithm

CAUTI Case Definition Algorithms

CAUTI Frequently Asked Questions

CAUTI Quick Reference Checklist

Hand Hygiene Observation Tool

Indwelling Urinary Catheter Supply Kit

Nurse-driven Protocol for Catheter Removal

Physician Reminder

Training

Introduction to CAUTI Collaborative Webinar (slides only)

Getting started using NHSN Webinar (slides only)

CAUTI Case Definition Webinar (slides only)

CAUTI Prevention Strategies
Collecting Summary Data for CAUTI Surveillance

Evidence-based Strategies for Prevention of CAUTI

Staff Education: Proper Insertion, Care, and Removal of Indwelling Urinary Catheter
Catheter Insertion and Removal Post Test

Collaboration Calls

January 2012 - Reporting CAUTI and Summary Data into NHSN (slides only)
February 2012 - Pre-Assessment Review and Documentation, Daily Assessment, and Staff Education (slides only)

March 2012 - Reminders, Stop Orders, and Nurse-driven Protocols (slides only)

April 2012 - Preparing for the Implementation Period (slides only)

May 2012 - Staff Education on Proper Insertion Care and Removal of Indwelling Urinary Catheters (slides only)

June 2012 - CAUTI Prevention Strategies (slides only)

July 2012 - no call

August 2012 - Physician Webinar on CAUTI Prevention Strategies and Treatment of UTI (slides only)

September 2012 - Data Update and Sharing Processes (slides only)

Additional Resources

APIC Guide to the Elimination of CAUTI 

HICPAC Guideline for Prevention of Catheter-associated Urinary Tract Infections, 2009

Please note: Florida has a very broad public records law. 

Most written communications to or from state officials regarding state business are public records available to the public and media upon request. 

Your e-mail communications may therefore be subject to public disclosure.

For questions and comments, please contact us at HAI_Program@doh.state.fl.us.