D221 Practice Improvement Plan Proposal
Situation (S)
A1. Healthcare Related Situation
Healthcare-associated infections (HAIs)—particularly Catheter-Associated Urinary Tract Infections (CAUTIs)—are a common systems-level patient safety risk in a hospital context. Urinary catheters can get colonized with germs and cause infections when they are not correctly inserted, maintained, or left in place for long periods of time (Monegro et al., 2023). CAUTIs are preventable, yet they nonetheless represent a serious risk to patient safety since they can lead to longer hospital stays, higher medical expenses, and even death. Furthermore, because CAUTIs frequently require the use of antibiotics for therapy, they add to the rising problem of antimicrobial resistance and complicate patient care and management.
Because healthcare delivery is multidimensional, addressing CAUTIs as a systems-level patient safety risk is complicated. The prevalence of CAUTIs can be attributed to various factors, including variances in clinician practices, limited staffing, and a lack of established guidelines (Werneburg, 2022). Moreover, the problem goes beyond providing care for a single patient to include more general hospital procedures like environmental hygiene, catheter insertion and maintenance procedures, and staff education and training. Mitigating the risk of CAUTIs and guaranteeing the safety of all patients within the healthcare system requires implementing comprehensive strategies, such as using catheter alternatives when feasible, encouraging appropriate catheter insertion and maintenance practices, and fostering a culture of infection prevention.
Background (B)
A2. Background Information
A2a. Data
The data presented by Werneburg (2022) and the Centers for Disease Control and Prevention (CDC) highlight the significant burden of catheter-associated urinary tract infections (CAUTIs) and the urgent need for change in current healthcare practices. CAUTIs are identified as the most common nosocomial infections, affecting approximately 1 million individuals annually in the United States alone (Werneburg, 2022). Moreover, CAUTIs are responsible for substantial healthcare costs, estimated to range from $115 million to $1.82 billion annually, underscoring the economic impact of these infections (Werneburg, 2022). The prevalence of CAUTIs is particularly pronounced in long-term care facilities, where 3–10% of residents are managed with chronic indwelling catheters, further exacerbating the risk of infection (Werneburg, 2022). Additionally, the CDC reports that on any given day, about 1 in 31 hospital patients has at least one healthcare-associated infection, with CAUTIs significantly contributing to this burden (Centers for Disease Control and Prevention, 2019).
Furthermore, the rise of antimicrobial resistance presents a formidable challenge in managing CAUTIs. Antibiotics, the cornerstone of CAUTI treatment, are increasingly met with resistance due to biofilm formation on catheter surfaces, limiting antibiotic penetration and efficacy (Werneburg, 2022). The CDC’s data on national and state-level healthcare-associated infections demonstrate progress and persistent challenges in addressing CAUTIs. While significant decreases have been observed in CAUTI rates, indicating some success in preventive measures, the overall prevalence of HAIs remains substantial, affecting a large proportion of hospitalized patients (Centers for Disease Control and Prevention, 2019).
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