1) Recruit a multidisciplinary team. The team included nurses
(clinical, educators, and scientists), physicians (hospitalists,
infectious disease), rehabilitation therapists and transport
personnel, infection control preventionists, central supply, and
clinical informatics representatives.
(2) Examine the evidence. An exhaustive literature review was
performed, and highlights from the literaturewere summarized
into an evidence table. Consensus guidelines and systematic
reviews were used extensively to plan the intervention.
(3) Identify and understand product use, availability, and costs.
Refine product use based on the best evidence and cost analysis.
Examine the following:
(a) IUC materials, sizes, kits, drainage bags;
(b) catheter securement devices;
(c) urinals and bedpan availability;
(d) commodes (availability and size);
(e) bladder scanners; and
(f) alternatives (incontinence pads, condom catheters, and
others).
(4) Measure outcomes. Work with infection control and clinical
informatics staff toaudit andmeasure outcomes Provide feedback
to staff. Potential measurable outcomes include the following:
(a) CAUTIs/1,000 catheter-days;
(b) catheter-days/hospital-days; and
(c) postoperative catheter-days/patient.
This project used the following framework for implementation: