Preventing pediatric catheter-associated urinary tract infections utilizing urinary catheter Kamishibai cards (K-cards) - 19/07/23
, Jennifer A. Ormsby, DNP, RN, CPN, CIC a, Jenny Chan Yuen, MSPH a, Gregory P. Priebe, MD b, c, d, Thomas J. Sandora, MD, MPH a, d, e, Ana M. Vaughan-Malloy, MD, MPH a, d, eHighlights |
• | Quality improvement project was initiated at a large, academic freestanding children's hospital for inpatients with an indwelling urinary catheter. |
• | An audit tool based on Kamishibai, a Japanese form of storytelling, was developed based on CDC CAUTI prevention recommendations. |
• | Hospital-wide urinary catheter K-card rounding facilitated standardized data collection, discussion of reliability, and real-time feedback to nurses. |
Résumé |
Background |
We instituted Kamishibai (K-card rounding) with the goals of improving indwelling urinary catheter maintenance bundle reliability and decreasing catheter-associated urinary tract infection (CAUTI) rates.
Method |
In a free-standing children's hospital, we undertook a hospital-wide quality improvement project from January 2019 to June 2021 after developing a K-card based on our urinary catheter maintenance bundle. Auditors used K-cards to ask standardized questions during weekly rounds. Bundle reliability and CAUTI rates were analyzed prospectively.
Results |
During the study period, 826 K-card audits were performed for 657 unique patients. While overall maintenance bundle reliability remained stable at 84%, there was a statistically significant improvement in reliability to the bundle element “medical discussion of need for the urinary catheter” from 88% to 94% (P = .01). The hospital-wide CAUTI rate significantly decreased (incidence rate ratio, 0.38; 95% CI, 0.15-0.93; P = .04).
Discussion |
Hospital-wide urinary catheter K-card rounding facilitated standardized data collection, discussion of reliability and real-time feedback to nurses. Maintenance bundle reliability remained stable after implementation, accompanied by a significant decrease in the CAUTI rate.
Conclusions |
Implementation of hospital-wide urinary catheter K-card rounding was associated with reduction in CAUTI rates. The project demonstrated likelihood of reproducibility with support of a multidisciplinary team.
Le texte complet de cet article est disponible en PDF.Key Words : Urinary tract infection, Quality improvement, Catheter-related infection, Kamishibai card, Infection prevention, CAUTI
Plan
| Conflicts of interest: None to report. |
Vol 51 - N° 8
P. 919-925 - août 2023 Retour au numéro
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