What’s New in the Patient Safety World
December 2016
The Joint Commission NPSG for CAUTI’s
The Joint Commission
has revised for 2017 NPSG.07.06.01, its national patient safety goal for
prevention of CAUTI’s (catheter-associated urinary tract infections).
The elements of
performance for NPSG.07.06.01 are:
- Educate staff and licensed independent practitioners involved in the
use of indwelling urinary catheters about CAUTI and the importance of
infection prevention. Education occurs upon hire or granting of initial
privileges and when involvement in indwelling catheter care is added to an
individual’s job responsibilities. Ongoing education and competence
assessment occur at intervals established by the organization.
- Educate patients who will have an indwelling catheter, and their
families as needed, on CAUTI prevention and the symptoms of a urinary
tract infection.
- Develop written criteria, using established evidence-based
guidelines, for placement of an indwelling urinary catheter. Written
criteria are revised as scientific evidence changes. (Examples are
provided in the document and we’ve provided them in our many columns on
CAUTI prevention listed below).
- Follow written procedures based on established evidence-based
guidelines for inserting and maintaining an indwelling urinary catheter.
The procedures address the following:
-
Limiting
use and duration
-
Performing
hand hygiene prior to catheter insertion or maintenance care
-
Using
aseptic techniques for site preparation, equipment, and supplies
-
Securing
catheters for unobstructed urine flow and drainage
-
Maintaining
the sterility of the urine collection system
-
Replacing
the urine collection system when required
-
Collecting
urine samples
(The NPSG acknowledges that there are certain medical conditions, predominantly
neurological ones, that require a prolonged use of an indwelling urinary
catheter in order to avoid adverse events and promote patient safety.)
- Measure and monitor catheter-associated urinary tract infection
prevention processes and outcomes in high-volume areas by doing the
following:
-
Selecting
measures using evidence-based guidelines or best practices
-
Having a
consistent method for medical record documentation of indwelling urinary
catheter use, insertion, and maintenance.
-
Monitoring
compliance with evidence-based guidelines or best practices
-
Evaluating
the effectiveness of prevention efforts
(The NPSG notes that surveillance may be targeted to areas with a high volume
of patients using in-dwelling catheters, as identified through the hospital’s
risk assessment.)
Of course, we are
advocates of incorporating your evidence-based criteria into your CPOE system.
That can help ensure appropriate use of catheters and may help you meet some of
the documentation requirements. Innovative hospitals will also use barcoding to
help create documentation for things like time of insertion, review for
continuation, etc.
This NPSG and all
the other 2017 National Patient Safety Goals are now available on The Joint
Commission website (TJC
2016).
Our other columns on urinary catheter-associated UTI’s:
- May 8, 2007 Tip of the Week “Doctor, when do I get this red rubber hose removed?”
- January 8, 2008 Tip of the Week “Urinary Catheter-Associated Infections”
- April 2008 What’s New in the
Patient Safety World column “More
on Nosocomial UTI’s”
- June 24, 2008 Tip of the Week “Urinary Catheter-Related UTI’s: Bladder Bundles”
- April 21, 2009 Tip of the Week “Still Futzing with Foleys?”
- June 9, 2009 Tip of the Week “CDC Update to the Guideline for Prevention of CAUTI”
- March 2010 “IDSA
CAUTI Guidelines”
- February 2011 What’s New in the Patient Safety World column “Catheters Not Needed in C-Sections?”
- January 2012 “CAUTI’s
Still Get No Respect”
- May 2012 “Foley
Catheter Hazards”
- November 2012 “CAUTI
Conundrum”
- December 18, 2012 “Unintended
Consequences of the CAUTI Measure?”
- January 2013 “Silver-Coated
Urinary Catheters Don’t Reduce CAUTI’s”
- June 2013 “Barriers
to CAUTI Prevention”
- November 2013 “Further
Reducing Urinary Catheter Use”
- June 2014 “Updated
HAI Prevention Guidelines from SHEA/IDSA”
- June 30, 2015 “What
Are Appropriate Indications for Urinary Catheters?”
- December 2015 “CAUTI
Prevention Tools”
- July 2016 “Holy
Moly, My Patient has a FOLEY!”
References:
The Joint Commission. Hospital Accreditation Program. National Patient Safety Goals Effective January 2017. Accessed November 18, 2016
https://www.jointcommission.org/assets/1/6/NPSG_Chapter_HAP_Jan2017.pdf
Print “PDF
version”
http://www.patientsafetysolutions.com/