Chasing Zero: Reducing CAUTIs in the MICU

Division of Pulmonary & Critical Care Medicine
CHASING ZERO: Reducing the Incidence of CAUTIs in the MICU

Kyle Enfield, MD, an assistant professor in the Division of Pulmonary & Critical Care Medicine, is director of UVA Hospital’s Medical Intensive Care Unit, and a member of its hospital epidemiology team. The MICU was a pilot site for UVA Health System’s Be Safe campaign, prior to full institutional roll-out last June. The ambitious goal of the Be Safe initiative is no less than making UVA the safest place to give and receive care in the country.

The MICU was part of the development and testing of standardized work practices to prevent catheter-associated urinary tract infections (CAUTIs). According to Dr. Enfield, “While we all hoped for an easy win, it proved harder than expected to provide exactly what the patient needed and no more.”

Dr. Enfield says that by learning from each event, the unit achieved 100 days without a CAUTI as of this past January. Prior to this, the MICU experienced an average of two to three infections per month. During the same period, the unit achieved a 50 percent reduction in the use of indwelling urinary catheters — measured in number of days catheters were indwelling — and went 150 days without a central-line-associated bloodstream infection, from a previous average of 1.5 such infections a month.

“We have achieved these results through daily interventional rounding and adherence to best practices in Foley insertion and maintenance,” Dr. Enfield says.

Read Dr. Enfield’s post on the CDC’s Safe Healthcare blog: “Success in Controlling Outbreaks in an ICU Using CDC Toolkit Interventions.“