759: Breaking the Cauti Cycle: A Multidisciplinary Initiative to Reduce Catheter-Associated Utis

Introduction: Catheter-Associated Urinary Tract Infections (CAUTIs) are among the most prevalent healthcare-associated infections, leading to increased morbidity, length of stay, and healthcare costs. This quality improvement project aimed to reduce CAUTI rates across hospital and ICU settings through evidence-based, multidisciplinary interventions. Methods: A baseline assessment of 12-month CAUTI data was conducted to identify high-risk units and practice gaps. Interventions included a nurse-driven catheter protocol requiring documented justification for insertion and promoting timely removal. An insertion bundle emphasized hand hygiene, aseptic technique, and sterile equipment, while a maintenance bundle focused on securement, drainage, daily review of necessity, and perineal care. Monthly diagnostic stewardship meetings with infectious disease specialists focused on improving clinician awareness regarding appropriate indications for urinalysis (UA) with culture, and identifying cases where a diagnostic UA alone is sufficient. Monthly staff education, competency validation, and real-time audit dashboards with unit-level feedback were implemented. EHR alerts with auto-expiry promoted standardized catheter management. While increased use of external (condom) catheters was encouraged, system data on utilization was not available for analysis. Results: From 2023 to 2024, hospital-wide CAUTIs decreased from 11 to 6 (45%) and ICU CAUTIs from 5 to 2 (60%). These outcomes exceeded the national CDC benchmark of an 11% reduction. Average monthly catheter days also declined by 19%, from 626.3 pre-intervention to 507.3 post-intervention (p = 0.096), suggesting a meaningful trend. Improvements were attributed to standardized catheter protocols, diagnostic stewardship, and enhanced staff engagement. Conclusions: A multifaceted CAUTI prevention initiative at Saint Agnes Medical Center significantly reduced infection rates and catheter use, outperforming national benchmarks. Nurse-led catheter removal protocols, insertion/maintenance bundles, EHR alerts, and diagnostic stewardship were key drivers of success. These findings highlight the importance of multidisciplinary collaboration and adherence to prevention bundles in reducing healthcare-associated infections.