Cauti Powerpoint

CAUTI Prevention
Definition of CAUTI
• Urinary tract infection that occurs in a

patient who had an indwelling urethral
urinary catheter in place 48 hours prior to
the UTI diagnosis and up to 30 days post
removal or discharge
• Does not include straight in & out catheters
or urinary catheters that are not placed in
the urethra
Background
• Urinary Tract Infections (UTI’s) are the

most common site of HAI’s
• Most UTI’s (80%) are associated with
urinary catheterization instrumentation
• UTI’s lead to increased morbidity, mortality,
LOS and cost
Background
• UTI’s account for

approximately 36% of all
HAI’s
Background
• According to the CDC,

UTI’s are directly related
to 5% of deaths associated
with HAI’s
Eliminate CAUTI: One infection at
a time
• Appropriate Indications: Does this patient need the
catheter?
• Ensure patient meets appropriate indications for catheter
use and document reason
• Consider alternatives to indwelling urethral
catheterization
Hand Hygiene: It starts with the
hands
• PRACTICE HAND HYGIENE and standard
precautions
• Sanitize hands thoroughly with an alcohol-based hand
rub or soap and water before and after catheter insertion
and manipulation
Insertion Technique: Pay attention
to detail
• Use sterile equipment including, sterile gloves,
drape, sponges, and appropriate antiseptic
solution
• Use aseptic technique to insert catheter. If
aseptic technique is broken, replace catheter
and collection system aseptically with sterile
equipment
• Secure catheter to prevent movement and
urethral traction
Catheter Maintenance: Keep it neat
• Keep collection bag below level of the

bladder at all times
• Check tubing frequently for kinking
• Keep drainage bag/tubing off the floor
• Empty the collection bag every four hours
or when ½ to 2/3 full
• Maintain a closed-drainage system
Catheter Care: Keep it clean
• Perform perineal care daily and after each

bowel movement
• Soap and water or perineal cleansing wipes
will be utilized
• Special care will be taken to remove fecal
soiling from around the catheter by cleaning
fecal material away from the urinary meatus
Catheter removal: Get it Out!
• Assess patient every shift for catheter need

• Take steps to remove catheter when patient no
longer meets indications
• Early removal of catheter using reminders or stop-
order “stickers”
Indications for catheter use
• Insert catheters only for appropriate indications

• Management of acute urinary retention
• Post-op bladder decompression for 48 hours
• Surgery procedure
• Monitoring urinary output in acutely ill patient
Indications for catheter use
• Contamination of stage III or IV pressure ulcers with
urine which has impeded healing, despite appropriate
care for incontinence
• Terminal illness or severe impairment which makes
positioning or clothing changes uncomfortable, or which
is associated with intractable pain
• Other – MD clarification required
Alternatives
• Alternatives to indwelling catheter

• Bladder ultrasound
• Intermittent catheterization
• Condom catheter
Organisms enter the bladder by 3
ways:
• At time of catheter insertion
• Through the catheter lumen (from a colonized
drainage bag)
• Along external surface of the catheter (migrate
along the catheter-mucosal interface)
Prevention
• Use general infection control practices

• Aseptic insertion
• Proper maintenance
• Hand hygiene
• Nurse driven Catheter Removal Protocol
• Education
Implementation of Evidence-Based
Prevention Strategies
• Make sure the catheter is indicated
• Implement and promote alternatives to indwelling
urinary catheterization
• Perform hand hygiene in compliance with CDC
• Provide education on proper insertion and maintenance
• Limit insertion of catheters to trained personnel
• Insert catheters using aseptic technique and sterile
equipment
Implementation of Evidence-Based
Prevention Strategies
• Secure catheter to prevent movement and
urethral traction
• Maintain closed drainage system
• Maintain unobstructed urine flow
• Remove catheters with 48 hours following
surgical procedure or document reason for
extended use
• Remove unnecessary catheters
Documentation
• Accurate documentation on the Urinary Catheter
Assessment in HMS
• Document medical indications for placement
• Insertion documentation (size of catheter used, patient
response, amount & color or urine obtained, etc…)
• Assess patient every shift for foley catheter removal –
includes scoring indications for maintenance of foley
• Discontinuation of urinary catheter documentation –
includes Bladder scanner Clinical pathway
documentation
• New alert sticker in physician orders to remind
physicians to discontinue foley catheters
Lessons Learned
• Use evidenced-based, standardized,

protocols and guidelines
• Build redundancy into the process – new
alert sticker placed in physician orders
• Define and enforce accountability
• Push accountability to the front line staff
Conclusions
• CAUTI is a common and costly safety problem

• Several practices appear to decrease CAUTI
• Preventing CAUTI is a “team” effort

Cauti Powerpoint

Uploaded by

Copyright:

Available Formats

Cauti Powerpoint

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Cauti Powerpoint

Uploaded by

Copyright:

Available Formats

CAUTI Prevention

• Urinary tract infection that occurs in a

• Urinary Tract Infections (UTI’s) are the

• UTI’s account for

• According to the CDC,

• Keep collection bag below level of the

• Perform perineal care daily and after each

• Assess patient every shift for catheter need

• Insert catheters only for appropriate indications

• Alternatives to indwelling catheter

• Use general infection control practices

• Use evidenced-based, standardized,

• CAUTI is a common and costly safety problem

You might also like