A program to prevent catheter associated urinary tract infection in acute care

@article{Saint2016APT,
  title={A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care.},
  author={Sanjay Saint and M. Todd Greene and Sarah L. Krein and Mary A M Rogers and David Ratz and Karen E. Fowler and Barbara S. Edson and Sam R. Watson and Barbara Meyer-Lucas and Marie Masuga and Kelly Faulkner and Carolyn V. Gould and James Battles and Mohamad G. Fakih},
  journal={The New England journal of medicine},
  year={2016},
  volume={374 22},
  pages={
          2111-9
        }
}

BACKGROUND Catheter-associated urinary tract infection (UTI) is a common device-associated infection in hospitals. Both technical factors--appropriate catheter use, aseptic insertion, and proper maintenance--and socioadaptive factors, such as cultural and behavioral changes in hospital units, are important in preventing catheter-associated UTI. METHODS The national Comprehensive Unit-based Safety Program, funded by the Agency for Healthcare Research and Quality, aimed to reduce catheter… 

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Urinary catheterisation is a common clinical procedure. While there are some benefits of catheters, there is a risk that a patient may get a urinary tract infection because of the device.

Catheter associated urinary tract infections (CAUTIs) have a significant burden on the health system. Those affected by a CAUTI are likely to have a hospital stay that is at least twice as long1,2, and costs twice as much3 than those without a CAUTI. A patient with a CAUTI is also more likely to acquire drug-resistant infections which may need treatment with more complex antimicrobial therapy4.

A program to prevent catheter associated urinary tract infection in acute care

CAUTI Improvement Project

The CAUTI Improvement Project was launched in 2016 to help health workers in reducing the number of CAUTIs in acute care settings. It is based on the basic principles for catheter insertion and management (see above) and provides decision support tools, clinician education, patient information, investigation tools, and promotional materials to promote better clinical practices.

The resources also help health facilities meet the requirements of the NSW Health Guidelines - Insertion and Management of Urethral Catheters for Adult Patients (GL2021_015) as well as the National Safety and Quality Health Service (NSQHS) Standards, particularly:

Criterion 3.8:

Developing and implementing a system for use and management of invasive devices based on the current national guidelines for preventing and controlling infections in health care

Criterion 3.9:

Implementing protocols for invasive device procedures regularly performed within the organisation.

  • CAUTIs Reading List - May 2016 PDF ~102KB

References

  1. Loveday, H.P., et al., epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infection, 2014. 86(1): p. s1-s7
  2. Daniels, K.R., G.C. Lee, and C.R. Frei, Trends in catheter-associated urinary tract infections among a national cohort of hospitalized adults, 2001-2010. American Journal of Infection Control, 2014. 42: p. 17-22.
  3. Jackson, T.J., et al., Marginal costs of hospital acquired conditions: information for priority setting for patient safety programs and research. Journal of Health Services Research and Policy, 2011. 16(3): p. 141-146.
  4. Chenoweth, C.E., C.V. Gould, and S. Saint, Diagnosis, management, and prevention of catheter-associated urinary tract infections. Infect Dis Clin N Am, 2014. 28(1): p. 105-119.

What is the best way to prevent catheter associated urinary tract infections?

CAUTI can be prevented by things such as hand washing, not using urine drain tubes and if they must be used, inserting them properly and keeping them clean. Catheters should be put in only when necessary, and removed as soon as possible.

What are some best practice nursing interventions that will help to prevent catheter associated urinary tract infection CAUTI )?

Appropriate Catheter Use.
Appropriate Indications. ... .
Inappropriate Indications. ... .
Consider Alternatives to Indwelling Urinary Catheters. ... .
Engaging Patients and Families. ... .
Properly Trained Clinicians. ... .
Aseptic Insertion. ... .
Appropriate Maintenance. ... .
Reminders and Stop Orders..

What teaching is helpful for preventing infections of the urinary system?

Children should be taught to keep their bottoms clean and dry and to change their underwear every day. Bubble bath products, detergents, shampoos or shower gels should not be used in bath water. They can irritate the opening to the urethra. Do not use colored or scented toilet paper.
ANA Initiative to Prevent CAUTI There are three areas to improve evidence-based clinical care to reduce the rate of CAUTI: (1) prevention of inappropriate short-term catheter use, (2) nurse-driven timely removal of urinary catheters, and (3) urinary catheter care during placement.