SHM Converge Scientific Abstract ePoster Gallery-Reducing the Standardized Infection Ratio of Observed/Expected Catheter-Associated Urinary Tract Infections in a Long-Term Acute Care Hospital

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Emory’s Long-Term Acute Care (LTAC) facility worked to reduce catheter-associated urinary tract infections (CAUTIs), which are common and costly hospital-acquired infections, especially in LTAC patients with complex conditions and prolonged catheter use. The project aimed to lower the facility’s Standardized Infection Ratio (SIR) from 6.76 in June 2023 to 1.58 by improving bladder management and monitoring key process metrics.<br /><br />The team identified multiple contributors to high CAUTI rates, including inconsistent urinalysis and urine culture ordering, incorrect indications for indwelling urinary catheters (IUCs), lack of IUC orders, poor documentation of catheter care, inconsistent use of bladder management algorithms, limited bladder scanner availability, and gaps in staff education and accountability. Additional issues included contamination risks from external sources, inadequate perineal care, and challenges with staffing and provider engagement.<br /><br />Interventions included finalizing and implementing a bladder management algorithm, launching a CAUTI Champions Program, educating nursing staff during huddles, providing provider-specific training on bladder management and straight catheterization protocols, improving sepsis and urine testing order sets, and using real-time audit/feedback to refine practices. The team also worked to strengthen accountability and standardize catheter care bundles.<br /><br />Results showed an improving trend in SIR from August 2023 through December 2025. Reported process metrics included a quality/patient safety SIR of 1.13, maintenance bundle audit completion, and bundle compliance around 79%–91%, depending on the measure. Key facilitators were staff education, bladder management protocols, urine testing algorithms, and champion support. Limiting factors included ongoing education needs for PRN and holiday staff, provider variability, and limited urology availability for voiding trials. A later increase in bioburden was partly linked to use of wipes containing dimethicone.

Asset Subtitle

Madhavi Chavan

Meta Tag

Author List Adhikar Acharya, Chennel Broom, Lori Grooms, Madhavi Chavan, Mary Ann K. Hall

Category Research

Concept Catheter-Associated Urinary Tract Infection

Concept Urinary Catheter

Concept Catheter Indication

Concept Standardized Infection Ratio

Concept Long-Term Acute Care Facility

Distinguished Non-Finalist

Presenter Organization Emory Healthcare

Presenting Author Madhavi Chavan

Track Quality Improvement

Keywords

catheter-associated urinary tract infections

CAUTI

long-term acute care

LTAC

standardized infection ratio

bladder management

indwelling urinary catheter

catheter care bundle

infection prevention

staff education

Catheter-Associated Urinary Tract Infection

Urinary Catheter

Catheter Indication

Standardized Infection Ratio

Long-Term Acute Care Facility