Using NHSN Definitions for Surveillance: Urinary Tract Infection (UTI) STANLEY OSTRAWSKI, MS, RN, MT(ASCP), CIC Infection Preventionist Consultant Objectives • Explain how to calculate a CAUTI rate • Explain how to complete NHSN UTI forms using CDC definitions and protocols • Apply case definitions of Urinary Catheterassociated infections to case studies Introduction – Urinary Tract Infections and Indwelling Urinary Catheters • The urinary tract is the most common site of HAI • Almost all UTIs are directly related to catheterization of the urinary tract • CAUTI can lead to complications such as pyelonephritis or bacteremia, CAUTI –Terms and Definitions Use CDC Definitions for the following: – – – – – CAUTI Indwelling catheter SUTI ABUTI OUTI Definition: CAUTI CAUTI is a urinary tract infection (UTI) that occurs in a patient who had an indwelling urinary catheter in place within the 48hour period before the onset of the UTI Definition: Indwelling Catheter • A drainage tube that is inserted into the urinary bladder through the urethra, is left in place, and is connected to a closed collection system. – Also called a Foley catheter – Does not include straight in and out catheters – Does not include suprapubic or nephrostomy catheters Rm # Name Ag Diagnosis Catheter IV e PICU - Monday, October 31, 2011 1:00 PM 106 Brandon Smith 6 Influenza PICC 107 Nicole Brown Aamina Bidouk Pneumonia Otitis Media Status epilepticus CVC – Femoral 108 18 mos. 3 109 Robin White 6 110 David Cranshaw 10 111 Susanna Solomon 112 Davey Blue 113 Amy O’Donnell – transferred to Surgical 6 Peds Ward at 11AM IPPB q 6 hr Tracheostomy, ventilator Viral meningitis Swan ganz PICC PIV X 2 7 mos Asthmatic bronchitis RSV pneumonia PIV right antecub CVC Jugular PIV right antecub Ventilator – weaning off IPPB q 6 hr 4 Pneumonia CVC – Subclavian Vent cont. PICC Vent . Extubated at 10:30 am – on room air Swan ganz CVC subclavian PICC Vent cont. 114 Brie Bennett 2 115 Harrison Black – admitted from ED @ 9 am 14 mos Foley to dd Resp Cath for spec. Foley out @ 10:30AM Repair – congenital heart defect Anaphalaxis to bee Foley to dd sting RSV pneumonia/congen ital heart disease Intubated in ED– on vent cont. Specimen Collection Urine specimens for culture should be processed as soon as possible, preferably within 1 to 2 hours. If urine specimens cannot be processed within 30 minutes of collection, they should be refrigerated, or inoculated into primary isolation medium before transport, or transported in an appropriate urine preservative. Refrigerated specimens should be cultured within 24 hours. Calculating the CAUTI Rate *Stratify by location type – •ICU or other location 2009 NHSN Report Edwards JR, et al. Am J Infect Control 2009;37:783-805 2011 NHSN Report Add Event Turning Data into Knowledge Have a plan to share the data with those individuals who can make a difference: •Nursing Staff •Medical staff •Administration •Board of Directors •Performance Improvement department •Patient safety leaders