AHRQ Safety Program for Long-term Care: HAIs/CAUTI

Engaging Residents and Familiesin

CAUTI Prevention

Content Webinar for Facility Team Leads and Core

Team Members

May 21, 2015

Sue Collier, RN, MSN, FABC

Clinical Content Development Lead

Health Research & Education Trust

American Hospital Association

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Learning Objectives

Upon completion of this session, participants will be able to:

• define resident-centered care;

• review the benefits of engaging residents and families as partners in care;

• describe examples of how to engage residents and families in reducing CAUTIs; and

• identify tools and resources you can use to educate staff, residents and families.

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What is Resident- and Family-Centered Care?

• A philosophy that keeps the person, the resident and their family at the center of

every decision-making process

• A way to assure residents’ preferences are valued and respected

• Care that reflects the core concepts of person-centered care

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What is Resident Engagement?

• An important component of resident-centered care

• An environment and culture that promotes residents, families, clinicians and all facility staff working together to improve quality and safety

• Recognition that residents and family are part of the team

• Actions that reflect the core concepts of resident-centered care

Consequences of Nursing Home Infections

• Leading cause of death and complications

• 150,000-300,000 admissions to hospitals from nursing homes each year

• Costliest of all adverse event-related hospitalization

• Prevention of these infections is critical in order to promote resident safety

Every number is a resident!

Montoya, Mody. Aging health. 2011 December ; 7(6): 889–899. doi:10.2217/AHE.11.80.Stone et al ICHE 2012.Smith PW et al ICHE 2008.

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Benefits to Engaging Residents and Families

• Residents and families have the ultimate concern for infections

• Residents and families can help the staff by

• Asking questions

• Identifying problems and solutions

• Staff can be more efficient and feel more valued in a resident-centered environment

• Facilities have better outcomes when there is shared decision-making

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CHAT: BENEFITS

What are some benefits of engaging residents and families in infection prevention?

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Achieving a Culture of Safety with C.A.U.T.I and T.E.A.M.S.

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Using T.E.A.M.S. To Engage Residents/Families

Team Formation

Excellent Communication

Assess What’s Working

Meet Monthly

Sustain Efforts

• Include the residents/families• Invite residents to planning meetings

• Encourage residents to speak up• Share information concerning the prevention efforts

• Share performance—ask residents if they can see a change in practice

• Share stories

• Share prevention information in Resident Council meetings• Include resident stories in safety meetings

• Include residents in new staff orientation and education• Include CAUTI prevention information in admission packets

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Using C.A.U.T.I. To Engage Residents/Families

Cather Removal

Aseptic Insertion

Using Regular Assessments

Training for Catheter Care

Incontinence Care Planning

• Tell residents/families you will assess need for catheter

• Share what you are doing to prevent UTIs

• Explain how you train staff to insert catheters properly

• Include resident council members in education

• Discuss alternatives to an indwelling urinary catheter

• Include family in discussions about catheter assessment

• Train residents/families in catheter care hygiene

• Explain the signs and symptoms; ask residents/family members to assist staff in assessments of UTI

• Ask residents and/or family members their preferences, needs and concerns

• Explain alternatives to catheters

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What Should Residents KnowAbout Urinary Catheters and CAUTIs?

• What is a urinary catheter?

• What is a CAUTI? How do I get a CAUTI? What are the symptoms?

• When should I NOT have a urinary catheter?

• What are the harms related to urinary catheter?

• If I already have a urinary catheter, what can I do?

• How can staff help me avoid needing a urinary catheter?

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CHAT: ENGAGEMENT

Describe what you do currently to engage residents and

families in preventing CAUTI or any infections?

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Summary: Examples of Resident Engagement

• Include residents and their family in care decisions

• Involve residents and their family in safety rounds

• Share resident stories in meetings

• Ask residents or family members to share their stories

• Provide CAUTI prevention education to residents

• Share what you are doing to help prevent infections

• Ask residents and family to help educate staff

• Develop education materials with residents and family

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CAUTI Tools and Resources for Residents and Families

LTC Safety Toolkit: Module 5Resident and Family Engagement

• Methods and tools for working with residents and families as partners

in their care to increase safety, improve satisfaction, and optimize

resident outcomes

• Ways to use the toolkit include:

Share videos with teams to spark engagement in staff safety

assessments

Provide templates and discussion guides to project leads

Educate teams on T.E.A.M.S. and Just Culture

Use videos and training modules to orient new staff

Train teams in using teamwork and communication tools

Engage senior leaders and project champions

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CHAT: CHALLENGES

What challenges have you had when engaging residents

and family in CAUTI prevention?

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Educating All Staff in Resident And Family Engagement in a Culture of Safety

• Use slide set with facilitator’s notes• Share recorded session for all staff• Use Discussion Guide with key questions to

spark conversations• Provide copies of T.E.A.M.S. and C.A.U.T.I

Infographics• Provide Evaluation Form and Certificate of

Completion

Your Role in Supporting Resident & Family Engagement in CAUTI Prevention (T.E.A.M.S.)

• Invite residents/families to serve on the safety teams; include resident stories in all safety improvement team meetings

• Encourage residents to speak up and communicate concerns

• Share information concerning the CAUTI prevention efforts

• Ask residents to their share stories

• Include safety information in Resident Council meetings

• Invite residents to participate in new staff orientation and education

• Include CAUTI prevention information in admission packets

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Your Role in Supporting Resident & Family Engagement in CAUTI Prevention (C.A.U.T.I.)

• Monitor and report small changes in a resident's condition

• Ensure proper catheter insertion and maintenance

• Train residents/family in catheter care hygiene

• Explain the signs and symptoms of UTI

• Discuss alternatives to an indwelling urinary catheter

• Include family in catheter assessments

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CHAT: ACTION STEPS

What will you do to engage residents and families in the

CAUTI prevention program?

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QUESTIONS?

Questions

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References

Agency for Healthcare Research and Quality. 2012. TeamSTEPPS® Long-term Care Version. Retrieved from http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/longtermcare/index.htm.

Advancing Excellence in America’s Nursing Homes: Person-Centered Care. Retrieved from http://www.nhqualitycampaign.org/star_index.aspx?controls=personcenteredcareexploregoal.

AHRQ CUSP Toolkit, Patient Family Engagement. Retrieved from http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/modules/patfamilyengagement/index.html.

Frampton, et al. Long-term Care Improvement Guide. Retrieved from http://planetree.org/wp-content/uploads/2011/12/LTC-Improvement-Guide-For-Download.pdf.

Association for Professional in infection Control and Epidemiology. Patient safety resources for consumers. Retrieved from http://www.apic.org/For-Consumers/Patient-safety-resources.

Institute for Patient and Family Centered Care. Retrieved from http://www.ipfcc.org/advance/topics.html.

Centers for Disease Control and Prevention. FAQs about Catheter-Associated Urinary Tract Infection. Retrieved from http://www.cdc.gov/HAI/ca_uti/uti.html.

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