Eliminating CAUTI: Interim Data Report

Results (continued)

Process Measures

Catheter Utilization Ratio

Catheter utilization ratios (reflected as a percent) can be found in Figures 12, 13, 14, and 15. Ratios examined were overall utilization ratio and utilization ratio by cohort, ICU status, and bed size.

Overall

The average catheter utilization ratio when aggregating the three baseline periods (BL–BL3) was 31.3 percent. Overall, catheter utilization has remained relatively the same over the time periods; however, some variability is present (go to Table 9 for relative change over time).

Due to the project's approach of staggered cohort implementation, catheter utilization rates for later time periods do not represent the complete data for all cohorts, as only cohorts 1–3 have reached the end of the project while all remaining cohorts continue to submit data. Therefore, caution must be exercised when interpreting relative reductions in later time periods.

Figure 12. Catheter Utilization Ratio During Baseline (BL) and Post-Baseline (P) Collection Periods – (Catheter Days/Patient Days)

A line graph shows the following: All units enrolled, overall catheter utilization ratio: 31.7 percent - first baseline period, 31.3 percent - second baseline period, 30.9 percent - third baseline period. Post baseline, overall catheter utilization ratio: 31.2 percent - period 1, 31.3 percent - period 2, 32.1 percent - period 3, 29.0 percent - period 4, 29.1 percent - period 5, 29.0 percent - period 6.

Note: n's represent the total number of reporting units for corresponding collection periods.

 

Table 9. Relative Change From Baselinea

  Post-Baseline Collection Periods
1 2 3 4 5 6
Units Reporting 1,046 986 873 679 435 324
Utilization
Ratio
31% 31% 32% 29% 29% 29%
Relative
Change
-0.3% -0.1% 2.5% -7.2% -7.0% -7.3%

a. Baseline aggregated over three baseline time periods (BL1–BL3).

 

Cohort Status

Figure 13. Catheter Utilization Ratio During Baseline (BL) and Post-Baseline (P) Collection Periods – By Cohort Status – (Catheter Days/Patient Days)

A line graph shows the following: Cohort 1 (57 units), catheter utilization ratio: 35 percent - first baseline period, 39 percent - second baseline period, 34 percent - third baseline period. Post baseline, the catheter utilization: 36 percent - period 1, 34 percent - period 2, 34 percent - period 3, 22 percent - period 4, 30 percent - period 5, 23 percent - period 6. Cohort 2 (215 units), catheter utilization ratio: 33 percent - first baseline period, 33 percent - second baseline period, 32 percent - third baseline period. Post baseline, catheter utilization ratio: 31 percent - period 1, 32 percent - period 2, 33 percent - period 3, 30 percent - period 4, 29 percent - period 5, 30 percent - period 6. Cohort 3 (270 units), catheter utilization ratio: 30 percent - first baseline period, 30 percent - second baseline period, 29 percent - third baseline period. Post baseline, catheter utilization ratio: 28 percent - period 1, 28 percent - period 2, 28 percent - period 3, 28 percent - period 4, 29 percent - period 5, 28 percent - period 6. Cohort 4 (417 units), catheter utilization ratio: 32 percent - first baseline period, 31 percent - second baseline period, 32 percent - third baseline period. Post baseline, catheter utilization ratio: 33 percent - period 1, 33 percent - period 2, 34 percent - period 3, 30 percent - period 4. Cohort 5 (92 units), catheter utilization ratio: 30 percent - first baseline period, 27 percent - second baseline period, 28 percent - third baseline period. Post baseline, catheter utilization ratio: 28 percent - period 1, 29 percent - period 2.

Note: n's represent the total number of reporting units for corresponding cohorts and collection periods.

ICU Status

Figure 14. Catheter Utilization Ratio During Baseline (BL) and Post-Baseline (P) Collection Periods – By ICU Status – (Catheter Days/Patient Days) 

A line graph shows the following: Non-ICU units (n = 623), catheter utilization ratio: 21 percent - first baseline period, 20 percent - second baseline period, 20 percent - third baseline period. Post baseline, catheter utilization ratio: 20 percent - period 1, 20 percent - period 2, 20 percent - period 3, 18 percent - period 4, 18 percent - period 5, 18 percent - period 6. ICU units (n = 428), catheter utilization ratio: 59 percent - first baseline period, 60 percent - second baseline period, 60 percent - third baseline period. Post baseline, catheter utilization ratio: 61 percent - period 1, 60 percent - period 2, 61 percent - period 3, 61 percent - period 4, 60 percent - period 5, 62 percent - period 6.

Note: n's represent the total number of reporting units for corresponding unit types and collection periods.

Bed Size

Figure 15. Catheter Utilization Ratio During Baseline (BL) and Post-Baseline (P) Collection Periods – By Bed Size – (Catheter Days/Patient Days)

A line graph shows the following: Units with more than 475 beds (n = 132), catheter utilization ratio: 39 percent - first baseline period, 40 percent - second baseline period, 39 percent - third baseline period. Post baseline, catheter utilization ratio: 39 percent - period 1, 39 percent - period 2, 42 percent - period 3, 41 percent - period 4, 39 percent - period 5, 44 percent - period 6. Units with 326 to 475 beds (n = 145), catheter utilization ratio: 31 percent - first baseline period, 30 percent - second baseline period, 32 percent - third baseline period. Post baseline, catheter utilization ratio: 33 percent - period 1, 33 percent - period 2, 33 percent - period 3, 27 percent - period 4, 30 percent - period 5, 26 percent - period 6. Units with 176 to 325 beds (n = 219), catheter utilization ratio: 35 percent - first baseline period, 34 percent - second baseline period, 33 percent - third baseline period. Post baseline, catheter utilization ratio: 33 percent - period 1, 33 percent - period 2, 33 percent - period 3, 31 percent - period 4, 30 percent - period 5, 32 percent - period 6. Units with 26 to 175 beds (n = 391), catheter utilization ratio: 26 percent - first baseline period, 26 percent - second baseline period, 25 percent - third baseline period. Post baseline, catheter utilization ratio: 26 percent - period 1, 26 percent - period 2, 26 percent - period 3, 25 percent - period 4, 23 percent - period 5, 22 percent - period 6. Units with 25 beds or fewer (n = 108), catheter utilization ratio: 22 percent - first baseline period, 21 percent - second baseline period, 20 percent - third baseline period. Post baseline, catheter utilization ratio: 18 percent - period 1, 19 percent - period 2, 20 percent - period 3, 20 percent - period 4, 19 percent - period 5, 19 percent - period 6.

Note: n's represent the total number of reporting units for corresponding bed sizes and collection periods.

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Culture Measures

Hospital Survey on Patient Safety Culture

The Hospital Survey on Patient Safety Culture (HSOPS) is a reliable and valid survey6 designed to assess clinician and staff perceptions of the culture of safety within their unit and overall hospital. The instrument contains seven unit-level safety culture dimensions, four hospital-level dimensions, and four outcome variables. To date we have collected over 700 baseline surveys, representing 56 percent of participating units, and over 300 followup surveys, representing 24 percent of participating units. 

Team Checkup Tool

Participating units were requested to complete a Team Checkup Tool (TCT) evaluating three primary domains: adoption of CUSP activities, implementation of CAUTI reduction steps, and progress barriers. While HSOPS is a validated survey looking at hospital safety improvements both before and after intervention, the TCT is designed to keep patient safety culture front and center at both the system and unit level. This is accomplished by the team working through the tool to identify common barriers, thereby providing the awareness and information needed to address issues related to patient safety barriers. TCTs are to be completed and submitted by unit teams quarterly throughout project participation. Currently, 628 TCTs have been completed across five cohorts, representing less than 60 percent of participating teams. Ongoing efforts continue to increase both HSOPS and TCT data submission. Future analyses will be conducted with increased submissions.

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6. Agency for Healthcare Research and Quality. "Safety Culture Dimensions and Reliabilities." User's Guide: Hospital Survey on Patient Safety Culture. AHRQ Publication No. 04-0041. Rockville, MD: Agency for Healthcare Research and Quality. September 2004. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/hospital/userguide/hospdim.html

Current as of July 2013
Internet Citation: Eliminating CAUTI: Interim Data Report: Results (continued). July 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/cusp/using-cusp-prevention/cauti-interim/cauti-interim4b.html