CAUTI and Innovation with the Continence Service

Debra Ollerhead

Continence Lead

National Context

• An indwelling catheter is a commonly used device

• Intervention should be as a last resort unless

contraindicated

• All patients should be offered a trial (Robinson 2005)

• NICE recommend a catheter should be reviewed regularly (2003)

Local Context

• Population size 330,000• Above older population than national average• 48 nursing homes• 48 residential homes• 4,000 reach 60 years of age each year• Indwelling catheters reached 500 in 2013 (audit 2013)• 50% not retention therefore potential for removal

Benefits of removal

• Urologists active with 6 in number locally• Reduced hospital episodes• Reduced CAUTI• Reduced prescribing spend• Reduced nursing input• Improved quality of life

Service Aims

• High quality service closer to home• Provide service for housebound• Reduce UTIs in relation to catheters• Reduce number to secondary care• Provide seamless discharge from secondary care• Provide choice for treatment options • Comply with best practice• Improve quality of life

Background

• Patients went to ward at local hospital for full day• Seen by generalist nurse• Only one attempt at removal• Relatives would often spend the day with patient• Impact on urology nurse when advice needed

Rationale for change

• Patient focus group• Closer to home• Dedicated nurse• Collaboration with colleagues in secondary care to

produce pathways• Patient information leaflets• Clinical and cost effective• Reduce potential harm from CAUTI

Findings at 6 months

• Over 75 referrals• 4-5 on average a week• Some TWOCS in hospital unsuccessful but successful in

community• Went live on 3rd March

From April 2014• Over 180 more catheters removed• Reducing potential CAUTI• Improving quality of life

Communication

• Hospital wards and departments visited• District Nurse bases• GP forums• District Nurse forums• Share progress with the Commissioners• Saves Lives!!!!

Any Questions?

Thank you