Speaker 1:
Welcome to today's onboarding session titled, Data Collection Training. This is
the 3rd of 4 onboarding modules for the Agency for Healthcare Research and
Quality, or AHRQ, Safety Program for Long-term Care, HAI/CAUTI. Part 1 of this
brief module is intended for all levels of long-term care staff and will introduce
you to your role in outcome data collection for the long-term care program.
Here are our goals for today's session. Attendees who complete this module, will
be able to: demonstrate a working knowledge of the data used to define CAUTIs
and the information collected; understand the importance of your role in
supporting data collection; and understand how quality data connects to overall
safety and quality of care for resident and staff.
Why is data important? For this project, data gives you and your facility the tools
you need to measure your progress in reducing CAUTI and improving safety
culture. Think about data the same way as a map. You start out on a trip and
hope to end up at a planned destination. In the same way, data helps you to
know and assess where you are and where you are heading. In the end, data will
tell you if you have met your goals and have been successful.
A designated team member, often the infection control nurse, will be your
facility's data coordinator. He or she will be responsible for coordinating your
facility's data collection. You may be asked to assist in collecting certain
measures at your facility.
You are probably wondering what data you will be involved in collecting for this
project. Data collection responsibilities will vary by facility depending on the
needs of your data coordinator. At each facility, the data coordinator will be
responsible for tracking the number of catheter associated urinary tract
infections, or CAUTI.
There are very specific criteria that are used to determine if a person has a
CAUTI, so it is important to have clear, concise documentation in the medical
record for accurate tracking. The outcome data definition flyer here provides you
with a snapshot of what we're collecting and why. The data you collect and enter
daily determines the rate of catheter utilization, CAUTI, and assesses if clinical
interventions are impacting the number of urine cultures sent.
You can use the data collection tool to document this data in one central
location. The tool will calculate these rates for you to make reporting this data
easy. The data that you, as the front line member, will most likely assist with
collecting for you facility is the number of residents in the facility each day of the
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month. This number includes all residents whether or not they have a catheter.
This number should be collected at the same time each day of the month.
Why is this number important? The number of residents in your facility will be
used to calculate the rates of infection in your facility. In order to calculate the
catheter utilization rate, it is important that you also collect the number of
residents with an in-dwelling urinary catheter sometimes called a Foley, each day
at your facility. The count does not include in-and-out catheters, suprapubic or
urostomies.
You learned in onboarding 2 that in-dwelling catheters are inserted into the
urethra and stay in place. Every day a resident has an in-dwelling urinary
catheter equals 1 catheter day. Nurses may request nursing assistance and
support staff to assist with collecting this information. On the unit, if a resident
normally has an in-dwelling urinary catheter and for some reason it was
removed, you may want to remind the nurse who is tracking this information
that the catheter is out and make sure not to count it.
Again, this number should also be collected at the same time each day of the
month. On the right side of this slide, you will see an example of a how a facility
will calculate the number of catheter days. It is not critical that you understand
this calculation, but it is important for you to know how important the data you
collect is.
A designated team member, often the infection control nurse, will track the
number of catheter associated urinary tract infections or CAUTI. There are very
specific criteria that are used to determine if a person has a CAUTI. It'll be
important to have clear, concise documentation in the medical record to allow
for accurate tracking. You will be provided with more training on this importance
of documenting the CAUTI and signs and symptoms you already learned about in
onboarding 2, during onboarding 4 on infection prevention surveillance.
Why is this number important? The number of residents in your facility will be
used to calculate the rates of infections in your facility. The nurse or other staff
members on a unit may be asked to help track and report how many urine
cultures were sent on a monthly basis for every resident whether or not they
have a catheter.
Why do we care about the number of urine cultures sent per month? Urine
cultures are often sent when residents do not have signs or symptoms of urinary
tract infections. One example may be a resident had a fall, so a urine culture was
sent to make sure the resident didn't have an infection. Many older adults,
especially those with long term, in-dwelling urinary catheters, have bacteria in
their urine at all times.
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Frequently, doctors will see bacteria in the urine culture results and immediately
treat the resident with antibiotics, even if the resident did not meet the criteria
for having a CAUTI or a UTI. You can see unnecessary urine culturing could lead
to residents being treated for an infection they don't have.
Unnecessary antibiotic use can lead to resident health complications, secondary
infections, and bacterial resistance. If there are less urine cultures sent, then we
will have less unnecessary antibiotic use. You will also learn more about the
importance of avoiding unnecessary antibiotic use during training module 4.
As we wrap up today's discussion, I'd like to leave you with a few questions to
discuss with your peers. What can you do to support data collection? Take a
second to think about your role in your facility. What are your daily tasks and
responsibilities? How might these daily tasks and responsibilities relate to the
data measures we discussed today? What can you do daily to insure accurate
data are collected at your facility?
Finally, how should staff at your facility be involved in data collection? What role
will charge nurses play? What about certified nursing assistance? Some facilities
may ask nurses to track and report the daily number of residents on their unit or
the daily number of residents with CAUTIs. CNAs might be enlisted to help count
the daily number of residents with a catheter.
Tracking procedures will vary by facility, but it is essential for all facility staff to
know the key information being following for this project. Those are resident
days, catheter days, number of CAUTIs, and the number of urine cultures
ordered. Onboarding 4 will provide you with more information on CAUTI
surveillance and reporting. Remember that all long-term care facility staff are
important in reducing CAUTIs and improving the safety culture.
The following resources are available to you as participants in the AHRQ Safety
Program for Long-term Care HAI/CAUTI Project. We hope that these resources
will be helpful on your journey to reduce CAUTIs and HAIs and improve your
facility's culture of safety. Resources include the first resource. This is an AHRQ
Safety Program for Long-term Care HAIs/CAUTI Project website. On the website,
you will find a variety of tools to help you prevent CAUTIs and improve your
facility's safety culture.
The second resource is a link to the TeamSTEPPS for long-term care web page.
TeamSTEPPS is a communication and team work system that offers solutions to
improve collaboration and communication within healthcare facilities. The
resources on this page are specifically designed for long-term care environment.
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The third resource is a link to the AHRQ Safety Program for Long-term Care
HAI/CAUTI Long-term Care Safety Tool Kit. The tool kit is designed to support
learning and implementation efforts to improve safety culture in long-term care
facilities. In 6 learning modules, the tool kit provides concepts and tools that aim
to change the way facilities do their work and provide care allowing for better
outcomes and higher quality of care for residents.
The fourth resource is a link to a downloadable version of the data collection
tool highlighted during this module.
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