Prevention of Catheter Associated Urinary

Tract Infection ( CAUTI )

Davinder Lell
Holy Names University
Dr. Pamela Stanley

Definition of CAUTI
A urinary tract infection (UTI) is an infection involving any
part of the urinary system, including urethra, bladder, ureters,
and kidney. UTIs are the most common type of healthcareassociated infection caused by mainly catheters, reported to the
National Healthcare Safety Network (NHSN).

Scope of CAUTI

Impact of CAUTI
The risk of CA-UTI increase 5% every day that an indwelling
urinary catheter remains in place.(AACN, 2009).
More than 30 million Foley catheters are inserted annually in
the United States, and probably contribute to 1 million
CAUTIs. (APIC.org, 2008).
A complications of CA-UTI can increase a patients hospital
length of stay from 2 days to 4 days.(APIC.org, 2008).
An additional average expense of $3,803 per episode, as
reported in an ICU CAUTI study. (APIC.org, 2008).

Expected Practice

Prior to placement of any indwelling urinary catheter, assess patient for

accepted indications and alternatives.
Adhere to aseptic technique for placement, manipulation, and maintenance
of indwelling urinary catheters.
Document all instances of indwelling urinary catheters, including insertion
date, indication, and removal date.
Promptly discontinue indwelling urinary catheters as soon as indications
expire.

Supporting Evidence
Prolonged catheterization is the major risk factor for CAUTIs.
Twenty-five percent of inpatients and up to 90% of patients in
an ICU have a urinary catheter during the hospitalization,
often without an appropriate indication.
CAUTIs can be decreased by interventions that facilitate
removal of unnecessary catheters.
Most hospitals have not implemented effective strategies for
preventing CAUTIs.

Actions for Nursing Practice

Develop written guidelines for urinary catheterization, include indications for

indwelling urinary catheterization, and ensure that catheter placement is limited
to patients who meet indications.
Have available devices, supplies, and techniques that allow alternatives to
indwelling catheters(e.g, condom catheters, penis pouches, bladder scanners,
incontinence products).
Design and implement standards and training programs for catheter insertion
and manipulation.
Review the necessity of catheter continuation for all the patients with urinary
catheters on a daily basis.
Develop systems to ensure prompt removal of catheters when no longer
indicated.
Implement infection surveillance programs that include unit-based urinary
catheter days and rates of CAUTIs.
Develop action plans to address needed improvements.

What is a CAUTI Bundle?

A collection of best practices identified by evidence-based
science as necessary to provide optimum care for patients in
certain circumstances involving particular risks to achieve the
goal of improved outcome.

Appropriate and Inappropriate indications for Catheter

Insertion
Appropriate Indications

Inappropriate Indications

Hospice Care
Neurogenic bladder
Obstruction/retention
Stage 3 or 4 pressure ulcer
Selected surgical procedures
Critically ill patient to monitor
urine output
Prolonged immobilization

Nursing care of incontinent

patients
A means of obtaining a urine
specimen when the patient can
voluntarily void
Prolonged postoperative duration
without indications

Eliminate CAUTIs

THANKS!!