CAUTI is the most frequently occurring healthcare-acquired infection and is associated with increased length of stay, morbidity, mortality, and overuse of antibiotics. Healthcare providers play an important role in preventing these infections. It is important to understand that in the course of everyday work, decisions about care of urinary catheters arise and we will be challenged to make the best decision consistent with evidence prevention practices.
It is vital that nurses develop the required skills to allow them to assess patients thoroughly before inserting a urinary catheter and to ensure that all other options have been investigated. Nurses with expertise in urinary catheterization must share their knowledge with new nurses and nursing students and ensure that their practice is based on the best evidence available. Patients with catheters need to be taught catheter care to minimize the risk of UTI. The caregivers of dependent patients need to be taught the skills required for catheter care as well.
Some risk reduction strategies that have been successful in many organizations include:
Implementation of the Bladder Bundle
- Aseptic technique when inserting a catheter
- Bladder ultrasound may avoid unnecessary catheterization
- Condom or intermittent catheterization in select patients
- Do not catheterize unless you must!
- Early removal of the catheter using reminders or stop orders
- Developing nursing protocols that clearly define criteria for insertion and removal of a catheter
- Incorporating prevention practices into order sets or pathways
- Having a zero-tolerance policy for adverse events. Reviewing each case to identify opportunities for improvement.
- Creating a culture in which healthcare providers are comfortable reminding each other when any breach in infection prevention practices is identified and in which we hold each other accountable for good infection prevention practices.
Infection prevention is everyone’s responsibility. Understanding your role in preventing infections is an important first step in protecting our patients and ensuring that that we provide safe patient care.