CA-UTI

Case for Change

• Evidence Based Clinical Guidelines
• Policies, Procedures, and Protocols
• Forms
• Educational Materials
• Other Tools

 

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Case for Change

Urinary tract infections are the most common type of healthcare-associated infections, accounting for more than 30% of infections reported by acute care hospitals.  According to the CDC, catheter-associated urinary tract infection (CAUTI) has been associated with increased morbidity, mortality, hospital cost and length of  stay. Indwelling catheters pose significant infection risks to patients.  Between 15% and 25% of hospitalized patients may receive a urinary catheter during their hospital stay, with as many as half not having an approoriate indication.

 Beginning October 1, 2008, the Centers for Medicare and Medicaid Services put into affect a rule to eliminate payment for preventable hospital-aquired complications, which includes CAUTIs. With this new rule, if a patient develops a CAUTI while in the hospital, the hospital will not be paid for care related to the infection.

CAUTI can be prevented by applying evidence-based prevention guidelines.

This toolkit will:

• Provide evidence based clinical guidelines for the prevention of catheter-associated urinary tract infections
• Provide current  policies and protocols
• Provide provider and patient educational materials 
• Provide examples of  forms and tools for use by hospitals

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Toolkit

Evidence Based Clinical Guidelines

• Centers for Disease Control
  Guidelines for Prevention of Catheter-associated Urinary Tract Infections provides epidemiology, control measures, and recommendations for catheter use and management.
   
• National Guideline Clearinghouse
  Prevention of catheter-associated urinary tract infections
   
• Healthcare Infection Control Practices Advisory Committee (HICPAC)
  Guideline for Prevention of Catheter-Associated Urinary Tract Infection

 

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Policies, Procedures, and Protocols

• Keokuk Area Hospital, Keokuk, IA
  Policy and Procedure for Prevention of Catheter-Associated Urinary Tract Infections
   
• Mercy Medical Center, Des Moines, IA
  Algorithm for Removal of Foley Catheter
   

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Forms

• Genesis Medical Center, Davenport, IA
  Poster - Guidelines for Urinary Catheter Need
   
• Genesis Medical Center, Davenport, IA
  Poster – Remove that Foley 
   
• Mercy Medical Center - Des Moines, IA
  Foley Catheter Order Sticker 

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Educational Materials

Provider Education

• American College of Chest Physicians
  This article discusses the use of antimicrobial-coated urinary catheters.
   
• American Medical Association
  This article discusses the various aspects of preventing catheter-related bacteriuria.
   
• American Society of Microbiology
  This article details the pathogenesis of CA-UTIs and discusses prevention.
   
• Association for Professionals in Infection Control and Epidemiology (APIC)
  On this site under Resources is a sample Risk assessment Chart and a Foley Catheter Prevalence Sheet.  Scroll down to Additional Resources to find a customizable brochure called, Promptly Remove that Foley. Also available is an information sheet and pocket cards for physicians and nurses entitled, Remove that Foley.
   
• CDC/NHSN
  This article contains the NHSN surveillance definition of urinary tract infection.
   
• Infection Control and Hospital Epidemiology
  This document highlights practical recommendations in a concise format to assist acute care hospitals in implementing catheter-associated urinary tract infection prevention efforts and provides recommendations on surveillance.
   
• Journal of Nursing Care Quality
  Click on PDF Version button to view this article that discusses a hospital project that used nursing education and staff development to improve care of patients with indwelling catheters and prevent UTIs.
   
• Wound, Ostomy and Continence Nurses Society
  This site provides a fact sheet on CA-UTI.
   

Patient Education

• First Do No Harm
  This site explains urinary tract infections and provides information to patients on how to reduce their risk of UTI if they have a urinary catheter in place.
   
• SHEA/IDSA
  FAQs about Catheter-Associated Urinary Tract Infection (Sponsored by the American Hospital Association, CDC, The Joint Commission and others) This document answers frequently asked questions by patients about CA-UTIs.

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Other Tools

• Health Protection Scotland
  CAUTI Maintenance Bundle
   
• Institute for Healthcare Improvement
  Click on the new "How-to Guide" to access the IHI Getting Started Kit: Prevent Catheter-Associated Urinary Tract Infections.  Also view the list of mento hospitals that have volunteered to assist hospitals with CAUTI improvement initiatives.  This link includes an additional list of tools and resources.
   
• Improvement Map
   Search the Institute for Healthcare Improvement's Improvement Map for details on the CAUTI care process.

 

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Success Stories

• If your organization has a success story you are willing to share in the toolkit, please contact Trula Foughty.
   

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Mentors

• IHC would like to thank those individuals and organizations who have shared their materials. If you would like to be a mentor on this subject, please contact Trula Foughty.
   

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Resources

• Journal of Nursing Care Quality
  Click on PDF Version button to view this article that discusses a hospital project that used nursing education and staff development to improve care of patients with indwelling catheters and prevent UTIs.

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