CAUTI GUIDE TO PATIENT SAFETY (GPS)

Question 1:
Do you currently have a well-functioning team (or work group) focusing on CAUTI prevention?
Yes No
Question 2:
Do you have a project manager with dedicated time to coordinate your CAUTI prevention activities?
Yes No
Question 3:
Do you have an effective nurse champion for your CAUTI prevention activities?
Yes No
Question 4:
Do bedside nurses assess, at least daily, whether their catheterized patients still need a urinary catheter?
Yes No
Question 5:
Do bedside nurses take initiative to ensure the indwelling urinary catheter is removed when the catheter is no longer needed (e.g., by contacting the physician or removing the catheter per protocol)?
Yes No
Question 6:
Do you have an effective physician champion for your CAUTI prevention activities?
Yes No
Question 7:
Is senior leadership supportive of CAUTI prevention activities?
Yes No
Question 8:
Do you currently collect CAUTI-related data (e.g., urinary catheter prevalence, urinary catheter appropriateness, and infection rates) in the unit(s) in which you are intervening?
Yes No
Question 9:
Do you routinely feedback CAUTI-related data to frontline staff (e.g., urinary catheter prevalence, urinary catheter appropriateness, and infection rates)?
Yes No
Question 10:
Have you experienced any of the following barriers?
 A.  Substantial nursing resistance
Yes No
 B. Substantial physician resistance
Yes No
 C. Patient and family requests for an indwelling urinary catheter
Yes No
 D. Indwelling urinary catheters commonly being inserted in the emergency department without an appropriate indication
Yes No