Education, best practices cut catheter infection rates
The number of bladder catheter infections per 1,000 device days reported by participants in the Infection Surveillance Project of the Missouri Alliance for Home Care (MAHC) dropped from 3.35 infections in the first quarter of 2005 to 2.68 in the fourth quarter of 2007.
While the decrease in infections is good, it does not present a true picture of what happens at individual agencies, points out Cyndee Howell, project manager for MAHC. "Because participating agencies typically drop out of the project when their infection rate reaches 1%, and new agencies typically come into the project with higher rates, we don't see a dramatic decrease in the overall project results," she explains. "We do know that participation in the project increases awareness of the risk of infection and helps agency staff members identify ways to reduce risk through communication with other participants."
In addition to collecting the surveillance data submitted by the participating agencies, MAHC hosts quarterly conference calls for participants to raise issues for which they need ideas and suggestions, and MAHC produces a participant newsletter that includes peer-to-peer advice, says Mary Schantz, executive director of MAHC. "We are trying to improve communications between participants so that we can share the knowledge gained through each agency's efforts to reduce infection," she explains.
When you have people from different agencies talking, you do obtain different perspectives, says Howell. "People will think outside the box and come up with ideas they might not have had on their own," she adds. An example of a problem raised in a conference call was one agency nurse who described a patient with sediment in the urine on a constant basis. The suggestion was made that dietitians work with the patient to develop a diet that might prevent infection. "The nurse discovered that the patient was drinking 2 liters of carbonated cola each day," she says. Once the patient decreased intake of the cola and increased clear fluids, the problem was resolved, she adds.
Myths are biased
Participants in the surveillance project not only have the opportunity to identify best practices, but they also have the opportunity to discover practices that are based on myth and "we've always done it this way" thinking rather than scientific evidence, says Schantz. As the nurses in the project learn more from other agencies, they go back to their own agencies to educate staff, physicians, and patients, she adds.
Rita Sansoucie, RN, BSN, staff development director of Phelps Regional Homecare in Rolla, MO, says, "I have been able to change some of the long-term habits of nurses because I can present data and experience from the surveillance project and other participants." While Sansoucie's agency has seen a decrease in the infection rate for patients with bladder catheters, she believes that participation in the surveillance project and ongoing discussion in staff education and team meetings about the agency's results and lessons learned from others has had the most positive effect on the infection rate. "I think when people are thinking about a specific issue, they pay close attention to activities that can affect an infection rate," Sansoucie explains.
In addition to ongoing education, Sansoucie's agency also has made bladder catheter care a part of the employee evaluation process. "We've incorporated it into our competency assessments," she says.
The number of bladder catheter infections per 1,000 device days reported by participants in the Infection Surveillance Project of the Missouri Alliance for Home Care (MAHC) dropped from 3.35 infections in the first quarter of 2005 to 2.68 in the fourth quarter of 2007.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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