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Neuro ICU, infectious disease team awarded for infection-reduction initiative

Friday, May 26, 2017
Team award photo

The Duke Neurosciences Unit (Neuro ICU) and members of the division of Infectious Diseases were recognized for their efforts to prevent catheter-associated urinary tract infections (CAUTIs), a major cause of death, disability, and increased hospital costs, with a “3D It Takes a Team” Award. The group received the award, which recognizes development, discovery, and delivery of improved health-care, on Monday, May 22.

The multidisciplinary group’s initiative produced a 60 percent reduction in CAUTIs in FY17, compared to a similar period of time over the last year as well as a cost savings of more than $9,000 since it was implemented last fall. Participants included members of the Neuro ICU as well as, clinical nurse specialists, advanced practice providers, infectious disease physicians, infection prevention nurses, and others.

"It makes me so proud to work with such a wonderful team who comes to Duke every day for all of the right reasons," said Keith Dombrowski, MD, medical director of the Duke Neuro ICU. "This effort, among others, continues to demonstrate our teams dedication to improving the care for our Neuroscience patients."

CAUTIs are the most common infection acquired in hospitals and are a national problem, particularly in neuro ICUs. Stroke patients, who often have compromised immune systems, are at particularly high risk. The group's initiative focused on decreasing the number of unnecessary urine cultures that were ordered and sent.  The team created a list of appropriate urine culture indications, based on the current medical literature and modified based on provider input, and then distributed this information via pocket cards, FAQ sheets, and posters in locations from workstations to bathrooms. The group also discussed the information in staff meetings.

Prevent CAUTIs
This poster, along with other material, offered simple ways to reduce unneeded urine cultures that could lead to CAUTIs.

"Each person in this multidisciplinary team was an integral part to the success of this initiative. Their contributions and support of this practice change exemplifies patient care excellence," said Staci Reynolds, PhD, RN, clinical nurse specialist for the Neuro ICU.

Building on this success, the group is working to spread this initiative to other areas within the Duke University Health System.

Key members of the initiative included (from left to right): Chris Sova (infection prevention), Erica Lobaugh-Jin (infection prevention), Staci Reynolds, (clinical nurse specialist), Keith Dombrowski (neuro ICU medical director), and Bob Blessing (nurse practitioner).

The "3D It Takes a Team Award" was created in 2012 to recognize teams at Duke University Hospital who have created powerful and sustainable processes that improve clinical care. The award is given for four categories of improvement: quality and patient safety, patient experience, finance and growth, and work culture.