CSI HWE

Can’t Spell PCU without U

Bayhealth Hospital, Dover, Delaware

CSI Summary

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Summary

CSI Presentation

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Presentation

CSI Toolkit

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Toolkit

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Project Topic:

Reduce CAUTI/CLABSI rates

Hospital, City and State:

Bayhealth Hospital, Dover, Delaware

Unit:

Progressive Care Unit

CSI Participants:

  • Candyce Collier, BSN, RN
  • Taylor Reynolds, BSN, RN

Project Goals/Objectives:

  1. Increase compliance with the CAUTI prevention bundle 60%
  2. Decrease the number of days patients spend with urinary catheter 15%
  3. Enhance adherence to CLABSI prevention measures, including CHG baths, decolonization procedures, and accurate documentation 60%
  4. Increase Healthy Work Environment Assessment Tool (HWEAT) Meaningful Recognition standard 10%
  5. Decrease CAUTI incidence 50%
  6. Decrease CLABSI incidence 50%

Project Outcomes:

  1. Increased compliance with the CAUTI prevention bundle to 94.3%
  2. Increased utilization of urinary catheters increased by 10%
  3. Compliance with the CLABSI prevention bundle is 85%
  4. Decreased HWEAT Meaningful Recognition scores 7%
  5. Decreased CAUTI’s 100%
  6. Decreased CLABSI’s 100%
  7. These outcomes resulted in a positive estimated annual fiscal impact of $113,541

Project Overview:

Our unit saw an increase in occurrences of CAUTI and CLABSI rates. The CSI team decided to focus our project on decreasing these occurrences. When we administered the HWEAT to the unit staff, the Meaningful Recognition standard was our lowest. To improve both the growing incidence of HAIs and our low meaningful recognition scores, we implemented a project that meaningfully recognized staff for their efforts in reducing CAUTI/ CLABSIs.

The CSI team kicked off our project in April 2024. During kick off, we provided staff with education and began giving out “PCU Bucks” as incentives to ensure CAUTI/CLABSI prevention bundles were being utilized. We also gave out bucks for nurses advocating for line removal and actual line removal. The “PCU Bucks” could be exchanged for prizes on the unit. Following the kickoff, we conducted weekly audits of all lines on the floor, continued rewarding with “PCU Bucks”, and began crowning a “CAUTI/ CLABSI Queen or King of the week.”

The implementation of this project sparked a positive change in our unit. While we did not improve the HWEAT Meaningful Recognition standard score, we did see a 100% decrease in both CAUTI and CLABSI rates. Nurses feel more confident questioning lines and initiating the urinary catheter removal protocol. The CSI team saw an increase in compliance with both the CAUTI and CLABSI prevention bundles. Implementation of this project benefitted both the nurses and patients on our unit.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.