Prevention of Catheter Associated Urinary Tract Infections in Stroke Patients (P1.009)

Objective: To evaluate the effectiveness of reduction of inappropriate catheterization of stroke patients to prevent CAUTI. Background: Urinary tract infections (UTIs) are a common complication in stroke patients and have been shown to cause an increased risk of death or disability at 3 months. Urinary catheters are responsible for most UTIs in hospitalized patients. Their inappropriate use has been brought into focus by various national quality organizations. CAUTI has been designated as a preventable and non- reimbursable condition by CMMS with direct costs running to several thousand dollars. They also significantly affect length of stay by several days. Few studies have evaluated CAUTI in stroke patients. Design: A protocol was developed to reduce inappropriate catheterization on stroke patients and implemented on November 1, 2013. CAUTI was defined per CDC guidelines. Patients admitted to the stroke service from January 2013 to July 2014 were included in this retrospective pilot study. CAUTI rates per 1000 catheter days and catheter utilization rates during the pre- intervention and post- intervention periods were calculated. Results: 1405 patients (ICH n= 209, CVA n= 1196) were included in the study period. Mean age was 64.7 and mean NIHSS score was 7.2 The mean CAUTI rate was 6.86 per 1000 catheter days during the 9 months pre-intervention and 3.32 during the 8 months post- intervention. The pre-intervention average catheter utilization rate in the stroke ward was 17.3 vs 12.8 post-intervention. The total number of CAUTIs pre-intervention was 12(6 Ischemic, 3 ICH and 3 stroke mimics). Post-intervention , CAUTI was detected in 3 ischemic strokes. Conclusion: Steps taken to reduce unnecessary catheterization resulted in reduced rates of CAUTI. The study could prove to be a useful pilot for a prospective study for the prevention of CAUTI in stroke patients and may help reduce comorbidities in this population. Disclosure: Dr. Aroor has nothing to disclose. Dr. Branson has nothing to disclose. Dr. Turner has nothing to disclose. Dr. Lee has nothing to disclose.