The Brooklyn Hospital Center convened a multidisciplinary group to conduct a failure mode and effects analysis (FMEA) study to reduce catheter-associated urinary tract infections (CAUTIs). The group identified possible effects that the failure of a process could have on patients and prioritized the failures by calculating the most severe failure modes. The team then used the FOCUS-Plan, Do, Check, Act performance-improvement methodology to identify causes, patterns, and trends in each CAUTI.
The project involved process and practice changes, comprehensive staff education, and correction and monitoring plans. Its main focus is on reinforcement and re-education of best practices including full barrier precautions for insertion, proper hand hygiene, daily assessment for ongoing use, and daily nursing maintenance outcomes and process measures.
As a result of the project, the ICU CAUTI rate decreased steadily, and the standardized infection ratio (SIR) remains below the national SIR and state average. The SIR for non-ICUs has remained below 1. The total number of infections decreased from 122 in 2014 to 24 events in 2015.