Partners in Prevention: Reducing CAUTI Rates Using Two Modalities of Simulation to Train Partners to Detect Indwelling Urinary Catheter Insertion Errors. (1090-003875) (Research Abstract Professor Rounds: Group 4)
Start time: Thursday, January 28, 2021, 1:00 PM End time: Thursday, January 28, 2021, 2:00 PM Session Type: Research Abstracts (Completed Studies)
Will simulation training for preparing registered nurses to serve as partners to detect errors during catheter insertion reduce CAUTI rates? UTIs are identified as the most common healthcare-associated infection with 75% of hospital acquired UTI's being associated with indwelling urinary catheter use.2. An estimated 13,000 deaths annually, is attributed to CAUTI as well as increased length of stay (LOS) by 2-4 days.1 Patients with CAUTIs may experience increased costs for their hospitalization of up to $2,800.3A Medical-Surgical unit at a 242 bed hospital experienced an increase in their CAUTI rate from 0 to 2.35 over a 6 month timeframe. The ICU is where catheters are commonly used and placed versus Medical Surgical areas leading to a gap in practice and knowledge for nurses working in those areas.4 . Engaging in different learning formats including videos, and high-fidelity simulations has proven to be an effective EBP approach to reducing CAUTI rates.3
A sample of 23 registered nurses were trained to properly insert indwelling urinary catheters using appropriate sterile technique via simulation as part of a quality improvement initiative. Two different modalities of simulation was used to conduct the training via this case study including simulation mannequins, labeled insertion kits, and videos. Participants were required to perform indwelling urinary catheter insertion independently and again with a partner while being observed by simulationist and unit's CNS. A checklist was used to ensure consistency in variables being measured. The same 23 participants then watched two videos (one correct, one with errors) of the simulationist and CNS inserting a urinary catheter. The participants used the same checklist to indicate errors detected in the video to garner if the simulation training was effective at preparting the registered nurses to serve as partners to their peers during indwelling catheter insertion.
Unpartnered subjects had an average total of 5.4 errors while partnered subjects had an average of 3.0 errors. A t-test for the difference in means yields a significance level (p<0.05) which supports the hypotheses that partnering subjects decreases the number of errors committed. On average, partnered subject decrease their errors by 2.4 per procedure. The next intervention involved participants watching a video and having to be able to identify errors made by the clinician inserting the indwelling catheter on video. Subjects detected on average 71% of the errors. Out of the 23 nurses who watched the video 11 ( ) of them identified 15 or more errors, 3 nurses identified more than 15 errors.
Using simulation to train nurses to detect errors in inserting indwelling urinary catheters were effective at reducing the CAUTI rate supporting the original hypothesis question. The data comparing indwelling urinary insertion between unpartnered and partnered participants was statistically significant in favor of the hypothesis. The nurses were able to detect errors and mitigate them after receiving training by use of a code word. The participants had to complete hands on simulation twice using a mannequin and then watch a video. The repeated practice improved participants skill and comfort level with using the new kits and being able to detect errors. After the training the nurses were instructed to accompany one another when inserting urinary catheters. The units CAUTI rate decreased back to zero after the training.
Co-Presenter: Jamie Rubin
Disclosure: No financial relationships with ineligible companies.