Tucson Medical Center: Leading the Way in Infection Prevention

Elizabeth: One of the things that we knew
about utilization around using urinary catheters in ICUs—it’s extraordinarily common. Almost
every patient was getting a catheter here a year ago. Elizabeth: Unfortunately, the care of these
catheters has become very inconsistent all over the country, and we have seen a real
rise of infections. Michelle: The risks of having a Foley catheter
placed are increased rates of urinary tract infection, which means increased antibiotic
use, which leads to increased antibiotic resistance. If the patient’s hospitalized, a Foley can
also lead to increased costs, increased length of stay in the hospital. Jenny: The challenge with Foley utilization
in the Critical Care really has to do with the fact that it’s a mentality that we have.
It’s almost a learned behavior. Elizabeth: We seek to be consistent and that
can be a real downfall in healthcare because, really, what has to happen is we have to look
at the patient individually. One of the first things that we did at this organization was
really start at the ground level and speak with the nurses about patients that had gotten
urinary tract infections from their catheters right here at our hospital, and we told their
stories. Jenny: They understood the purpose and why
we’re doing it because – that’s the other thing – is bringing the evidence-based education
to them saying, “You know, jeez, one-in-ten people will die from their CAUTI.” This can
save lives. Nina: We work with standardized infection
ratios and the data is shared at every team meeting. We found that tracking device utilization
for the ICU we were at about the 90th percentile consistently, and after interventions we were
able to drop down to about the 50th percentile. So it really has been a tremendous change,
but a change in culture and identifying inappropriate use and then really showing the data in the
science to indicate that we could do without. Jenny: We, as a Critical Care, made some great
strides, but it wasn’t us independently. It’s a hospital-wide- it’s a team effort from every
department. Jessica: The doctors were involved, Emergency
Services, ICU the floors. Nina: Our chief nursing officer came on board,
on the team, and she was actively engaged in our team, and it really does make all the
difference in the world. Elizabeth: leadership has got to show up to
the table. They’ve got to go to the meetings. They’ve got to slog through the work. Aunne: The leadership has supported reducing
catheter infections by really pushing forward the new products and doing the research on
different companies and different product brands that we can use, and then bringing
them to our department for us trial. Patient: They’ve got all the personnel trained,
they all cooperate with each other, and the equipment and the place is just marvelous. Jenny: As a nurse, you know, inherently, we
want to do good — so to know that some of the simple devices that we utilize can actually
cause harm, you know that’s a concern. Michelle: That’s what motivates people to
make changes and not just to do what’s easy for them because they want to do what’s best
for the patient and for the hospital, as well. That’s important. Elizabeth: It’s a package deal. Data is powerful,
but what’s even more powerful? What potentiates the data is the reality of what happens to
the patients. That’s what really drives the improvement. Aunne: I’m grateful to see the change and
the culture change in my department. I’m so grateful to see less infections. Nina: I take these infections personally.
These are patients. These are people. So we want to make sure our patients are protected.

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