Atlanta Children’s Hospital reaches zero cautis on the PICA due to the revolutionary strategy “NAPULY ZONE”

The targeted healthcare initiative for kids in Atlanta eliminated urinary tract infections related to the catheter (Cautis) on the Intensive Pediatric Therapy Department (PiKu), coping with persistent challenges regarding prevention with strategies specially designed for kids.

Cautis remain probably the most common health care infections amongst adult and pediatric patients, which ends up in greater hospital stay, higher costs and increased risk of the patient. Although there are national guidelines for prevention, they’re largely based on adult data, leaving the gap within the approaches specific to pediatrics.

Study published in Critical care nurse Detailed information on how the Inter-Taby Task Group on a 56-person hospital ICI of Przemyśl his preventive efforts, integrating latest protocols with recognized best practices.

From lasting infections to an enduring zero speed

Before the initiative began in 2020, the Cauti indicator from PICA was 3.13 per 1000 days of the catheter, and on average 92 days between events. A 12 months after implementation, the speed dropped by 22% to 2.44 per 1000 days of the catheter, extending the typical time between events to 129 days. Until 2023, the team reached a zero indicator for 1000 days of the catheter, maintaining 527 consecutive days off from events from July 2022.

“No diaper zone”

One of essentially the most influential changes was the introduction of the No Daper zone.

“Our intervention of the No Daper zone coped with the aspect of preventing Cauti, which was not widely discussed in existing guidelines,” said co -author Kathryn Cabral, BSN, RN, CCRN, Critical care Coordinator for the protection of patients and clinical patients in kid’s health care in Atlanta. “Thanks to the limited direct evidence, we focused on solving the likely urinary tract paths to be contaminated with a stool or urine flow.”

Thanks to the review of cases, the team identified the repeated pattern of liquid stool amongst patients from Cauti, which suggests possible pollution of catheters. Diapers were removed as an answer for all patients with a pic with urethra. Highly absorbent pads replaced diapers, and nurses checked the stool every two hours during life parameters and changes in position, enabling quick cleansing and reduction of the danger of exposure.

Improved urine monitoring

In the case of patients with urinary catheters on the spot for longer than 72 hours-the Cauti-Picu risk factor has replaced traditional collector’s bags depending on the advanced gravity with the Accurin system. This configuration uses delicate sucking, has three one -way valves to stop reflux, and accommodates integrated sensors for the thorough urine output, which is displayed digitally. After a successful attempt, the system expanded to the ICU Cardiac and the operating room.

Education of staff and oldsters

Preventive efforts also focused on education.

• The staff received training during weekly rounds of prevention of infections and latest orientation, with practical demonstrations of the precise technique.
• Parents were informed in regards to the justification of the No Daper zone and their role in reducing the danger of pollution.

By combining practices based on evidence with innovations focused on pediatrics, the PICA team showed that zero cautis is an achievable and balanced goal.

Full examination, “Introduction of the No Diaper zone: rething prevention of urinary tract infection associated with the catheter“ It is accessible within the Critical Care nurse, American Association of Critical-Care Nurses Bimonthly Clinical Practice Journal.