Rounding: A Way to Improve Staff Awareness of Foley Process

1. Rounding: A Way to Improve Staff Awareness of Foley Process

2. AIM Improve staff understanding: • Foley indications • Foley removal when no longer needed

3. Rounds by CEO and IP • Implemented a couple of years ago • Central lines, MDRO’s • Checklist • Reward • Visit a nursing area each month • Ask staff questions related to above process • March 2012-Suggested to change focus to foleycatheters, general information

4. What did we notice during rounds? • Staff could answer questions about the care of a foley • Staff couldn’t consistently answer questions about our hospital indications for inserting a foley • Staff didn’t seem to understand the importance of asking the physician each day if they could take the foley out • What did staff notice? • Support of the CEO for our process • CEO asked questions during the rounds

5. Expanded Rounds • April 2012, CNO joined foley rounds • Monthly rounds • Staff can “feel” the presence/support from administration for our foley process • May 2012 implemented weekly ACNO and IP rounds in all nursing areas • More direct rounds-one on one • Nurse leaders

6. Foley Catheter Rounding Data Date:_______________

7. Are the rounds making a difference? YES!!!! • Staff are beginning to verbalize the indications to us and to each other • Staff are starting to be more comfortable asking physicians if the foley can be discontinued • Culture is starting to change • Increased engagement/excitement by nursing staff

8. Nurse Engagement/Excitement Rounds a couple of weeks ago: • Nurse couldn’t tell us the real indication for the foley • Nurse had not discussed the foley with the physician Rounds last week: Same nurse • Engaged nurse • Excited nurse

9. What have we gained from rounding? • Increase knowledge by our staff about foley insertions for right reasons and removed when no longer needed (measuring in process) • Decrease in CAUTI in one area that had recently had an increase • HEN program unit • Zero since early January • Incidental gain from rounding: • A couple of processes will be reviewed to assure best practice is in place • Discovered that we an opportunity to review our stock of catheters