878Sustained Reduction in Catheter-associated Urinary Tract Infection (CAUTI) Rates Using a Collaborative Program Approach

Background. Approximately 15-25% of hospitalized patients receive a urinary catheter during their hospital stay. Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter. Methods. Our hospital, a large tertiary-care facility with a substantial spinal cord injury population and on-site nursing care center, were experiencing significant symptomatic CAUTI rates. We implemented a collaborative CAUTI prevention program in late 2011 using our MICU and one ward as trial areas employing a closed system silver urinary catheter (SUC) trial for two weeks with concurrent targeted intense nursing and support staff education of proper insertion and maintenance of SUC with no CAUTI during the trial; weekly CAUTI tracers were used to monitor practices. A second trial was conducted early 2012 for 7 months within all acute care units, emergency department, and nursing care center involved; weekly tracer monitoring continued. Results. Our CAUTI rates declined from 5.1/1,000 urinary catheter days (UCD) late 2011 (pre-intervention) to 3.5/1,000 UCD in early 2012 with the first trial implementation; this further decreased to 1.4/1,000 UCD overall rate with the full hospital implementation in 2012. Our overall CAUTI rate for 2013 was 1.1/1,000 UCD. Conclusion. Our overall collaborative approach which involved: engagement of frontline staff in targeted education on maintenance of indwelling urinary catheters and CAUTI prevention efforts; a strong interdisciplinary clinical focus; greater spread of evidence-based practice standards through the use of SUC technology; and excellent communication, contributed to the significant and sustained aggregate reduction of symptomatic CAUTI incidence rates throughout our inpatient care areas. Disclosures. All authors: No reported disclosures.