South Carolina Hospital’s Use of AHRQ Patient Safety Program Leads to Significant Drop in Urinary Infections
Implementation of an AHRQ patient safety program helped the Medical University of South Carolina (MUSC) hospital reduce catheter-associated urinary tract infections (CAUTI) from 8.6 percent in 2012 to 1.1 percent in 2015.
The patient safety resource—AHRQ's Comprehensive Unit-based Safety Program (CUSP)—is designed to prevent infections that can increase the length of hospital stays and costs, intensify patient suffering, and even lead to death.
"At MUSC, we are committed to promoting a safe patient environment that minimizes urethral catheter use and infection risk through consistent and reliable care," said Danielle Scheurer, M.D., M.S.C.R. Dr. Scheurer is the health system’s chief quality officer.
The MUSC infection prevention team focused on achieving zero CAUTIs by improving and standardizing catheter care steps: pre-insertion, insertion, maintenance, and removal.
Key to MUSC’s success in reducing CAUTI rates has been the use of AHRQ's CUSP poster, "AHRQ Safety Program for Reducing CAUTI in Hospitals" (PDF, 19 MB).
Because catheters are often inserted unnecessarily, the team studied urinary catheter insertion at MUSC to assess whether catheters were being used appropriately. They found that catheter use varied depending on the hospital department performing the procedure.
The team implemented staff education on the appropriateness of catheter use in all departments that use them, from the operating room to the radiology department.
MUSC also installed a "best practice" alert through the hospital's electronic health record system. The alert goes off 24 hours after a catheter is inserted and reminds physicians about the continuing use of the catheter every 48 hours, asking whether it should be continued. In addition, nurses are encouraged to use an "Early Discontinuation Protocol" that allows them to remove a catheter without a physician’s order when it is no longer indicated.
MUSC's success in reducing CAUTI rates contributed to the hospital's achieving Magnet status from the American Nurses' Credentialing Center. The following chart shows the hospital’s success in reducing CAUTIs over a three-year period, starting in 2012: