Toolkit for Reducing Catheter-Associated Urinary Tract Infections in Hospital Units: Implementation Guide

Appendix P. Interpreting CAUTI Data Trends

Use these tables to evaluate your data submission rates and outcome data results by comparing your rates to the tables.





CAUTI DATA SUBMISSION: Look at both outcome and process data submission rates
  Outcome Data Submission Process Data Submission Suggested Actions/Questions To Consider 
  At least 80% and same or better than  last month At least 60%  and same or better than last month Congratulate team; continue current work/data review
  At least 80% and same or better than last month Less than 60% OR worse than last month Does team understand the rounding process? Have they designated a lead person for rounding? Any barriers to data submission?
  Less than 80% OR worse than last month At least 60% and same or better than last month Is team working with their Infection Control department to obtain this data? Any barriers to data submission?
  Less than 80% OR worse than last month Less than 60% OR worse than last month Does team intend to actively participate?  Review all the above actions with them What are their barriers?
       
CAUTI DATA REVIEW:  Look at 3 Parameters: CAUTI Rates, Percent of Patients with at least one appropriate indication, and Outcome Prevalence. Use one of the two tables below.
If CAUTI Rates are DECREASING (Favorable Trend): Look at % of Patients  with Appropriate Indication and Outcome Prevalence and use this table:
CAUTI Rate % with Approp Indication Prevalence (outcome data) Suggested Actions/Questions To Consider 
Favorable (decreasing) Favorable (increasing) Favorable (decreasing) Congratulate team; continue current work/data review
Favorable (decreasing) Favorable (increasing) Unfavorable (increasing) Has case mix changed so more patients appropriately need catheters? Is unit doing daily rounding for removal?
Favorable (decreasing) Unfavorable (decreasing) Favorable (decreasing) Revisit staff education re: appropriate HICPAC indications
Favorable (decreasing) Unfavorable (decreasing) Unfavorable (increasing) Revisit staff education re: appropriate HICPAC indications;  Is unit doing daily rounding for removal?
 
If CAUTI Rates are INCREASING (Unfavorable Trend): Look at % of Patients with Appropriate Indication and Outcome Prevalence and use this table:
CAUTI Rate % with Approp Indication Prevalence (outcome data) Suggested Actions/Questions To Consider
Unfavorable (increasing) Favorable (increasing) Favorable (decreasing) Is rate up due to smaller denominator (catheter days)? Are there catheter insertion or care/maintenance issues?
Unfavorable (increasing) Favorable (increasing) Unfavorable (increasing) Are there catheter insertion or care/maintenance issues? Is unit rounding daily for removal?
Unfavorable (increasing) Unfavorable (decreasing) Favorable (decreasing) Are there catheter insertion or care/maintenance issues? Revisit staff education re: appropriate indications
Unfavorable (increasing) Unfavorable (decreasing) Unfavorable (increasing) Are there catheter insertion or care/maintenance issues? Revisit staff education re: appropriate indications; Is unit rounding daily for catheter removal?
Page last reviewed October 2015
Page originally created October 2015
Internet Citation: Appendix P. Interpreting CAUTI Data Trends. Content last reviewed October 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/hais/cauti-tools/impl-guide/implementation-guide-appendix-p.html