TAP Catheter-Associated Urinary Tract Infection (CAUTI) Implementation Guide: Links to Example Resources

Engagement of Leadership, Champions, and Staff

• Engage the Senior Executive Module – Comprehensive Unit-based Safety Program (CUSP) Toolkit
  Curriculum focused on the role and responsibilities of senior executives, from the Agency for Healthcare Research and Quality (AHRQ)
• CAUTI Cost Calculator
  Tool to engage leadership that estimates facility costs due to CAUTI, from catheterout.org
• Implementation Team Roles and Responsibilities [PDF – 1 page]
  Summary of recommended personnel to engage for CAUTI reduction efforts, from catheterout.org
• CUSP Board Checklist
  Checklist of activities to involve for senior leadership in the prevention of patient harm, from the Agency for Healthcare Research and Quality.
• CDC Safe Healthcare Blog – Why So Many Foleys?
  Discussion of best practices for managing urinary catheters and reducing risk of CAUTI, guest author Wendy Kaler, MPH, CIC, Dignity Health
• Strategies and Tips for Engaging Providers
  Resources to engage senior leaders, physicians, nurses as champions in CAUTI prevention located under the tab” Engaging Providers”, from catheterout.org
• Presentation to Nurse Manager & Case Manager (or Unit Champion)
  Agenda for presentation to unit champion, from the Agency for Healthcare Research and Quality, CUSP Toolkit
• Infection Prevention Champion
  Informational webpage and accompanying PDF to aid partners in the identification and guidance of infection prevention champions, from CDC
• Quick Observation Tools (QUOTS)
  Easy, quick tools arranged by themes (e.g. transmission-based precautions, device-associated infections, high-level disinfection, etc.)for infection prevention that can be used by healthcare providers primarily responsible at the location being assessed, from APIC

Staff Training and Competency Assessments

• CAUTI Prevention Training [PDF – 2 MB]
  Training module for CAUTI prevention, covering CAUTI risks and prevention, from Sharp HealthCare
• Streamlined Evidence-Based RN Tool [PDF – 2 pages]
  Nurse-driven indwelling urinary catheter tool, including insertion checklist and bladder scan protocol, from the American Nurses Association
• Bladder Scan Policy and Checklist
  Policy for use of bladder scanners, from the On the CUSP: Stop CAUTI Implementation Guide
• Appropriate Urinary Catheter Use and Management Nursing Education [PDF – 54 pages]
  PowerPoint slide set on appropriate urinary catheter use and management, from catheterout.org

Routine Audits

• Appropriate Urinary Catheter Placement in the ED
  Checklist of appropriate indications for ED patients, data collection forms (pgs. 15-18), from On the CUSP: Stop CAUTI Implementation Guide.
  Metrics for ED Catheter Placement and Catheterization Rates with calculations for inappropriately placed catheter rates in the ED (pg. 19). ENA requires log-in
• Guide to Preventing Catheter-Associated Urinary Tract Infections [PDF – 1.76 MB]
  Data collection tools for catheter appropriateness and insertion found on pg. 23 (Figure 2.2) and pg. 45 (Table 5.1), from the Association for Professionals in Infection Control and Epidemiology (APIC)
• Streamlined Evidence-Based RN Tool [PDF – 80 KB]
  Nurse-driven indwelling urinary catheter tool, including insertion checklist, from the American Nurses Association
• Urinary Catheter Insertion Checklist [PDF – 1 page]
  Checklist of best practices for Foley insertion, reprinted by the Pennsylvania Patient Safety Authority with permission from Doylestown Hospital
• Female Insertion Audit Checklist [PDF – 2 pages]
  Checklist of critical behaviors for use in auditing insertion practices in FEMALE urinary catheterization, reprinted by the Pennsylvania Patient Safety Authority with permission from Doylestown Hospital
• Male Insertion Audit Checklist
  Checklist of critical behaviors for use in auditing insertion practices in MALE urinary catheterization, reprinted by the Pennsylvania Patient Safety Authority with permission from Doylestown Hospital
• Implementing a Nurse-Driven Protocol [PDF – 751 KB]
  Foley Catheter Practice Survey Tool (Figure 1, p. 18), from MedSurg Nursing
• Hospital Infection Control Worksheet [PDF – 1.73 MB]
  Data collection tool (Section 4.A., pg. 28-30) for assessment of aseptic insertion and appropriate maintenance for surveyors, from the Centers for Medicare & Medicaid Services (CMS)
• Urinary Catheter Audit Form
  Checklist (pg. 1) to collect data on appropriate catheter maintenance during facility/unit audits, from St. Patrick Hospital and Health Science Center and IHI (requires log-in)

Example Resources

• The Ann Arbor Criteria for Appropriate Urinary Catheter Use
  Appropriate and inappropriate indications for catheter use in hospitalized medical patients (Table 2, pg. 8), and a daily checklist for appropriate indications in the ICU (Figure 4, pg. 14), from the Annals of Internal Medicine
• Guideline for Prevention of CAUTI, 2009
  Appropriate indications provided in Table 2 (pg. 11), from the CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC)
• Bladder Scan Policy and Checklist
  Policy for use of bladder scanners, from the On the CUSP: Stop CAUTI Implementation Guide
• Streamlined Evidence-Based RN Tool [PDF – 2 pages]
  Nurse-driven indwelling urinary catheter tool, including CDC criteria, insertion algorithm, and bladder scanner protocol, from the American Nurses Association
• Implementing a Nurse-Driven Protocol [PDF – 751 KB
  Evaluation of nurse-driven catheter removal protocols in the acute care setting, from MedSurg Nursing
• Policy/Procedure for Perineal Care for the Incontinent Patient [DOC – 52 KB]
  Perineal care procedures as alternatives to catheterization for incontinent patients, from the Virginia Department of Health
• Catheterization Alternatives Flyer [PDF – 1.44 MB]
  Flyer presenting best practices and alternatives to indwelling catheters (pg. 4), from the South Carolina Hospital Association
• CDC Safe Healthcare Blog – Why So Many Foleys?
  Discussion of best practices for managing urinary catheters and reducing risk of CAUTI, guest author Wendy Kaler, MPH, CIC, Dignity Health
• CAUTI Prevention Brochure
  Brochure for providers summarizing indications for catheter use, from the On the CUSP: Stop CAUTI Implementation Guide
• Strategies to Prevent CAUTI in Acute Care Hospitals: 2014 Update
  Practical recommendations for CAUTI prevention for acute care hospitals, including a catheter reminder/removal checklist (pg. 8), from The Society for Healthcare Epidemiology of America (SHEA)
• Pocket Cards for Providers [PDF – 1 page]
  Catheter removal reminder tools for use by physicians and nurses, from catheterout.org
• Urinary Catheter Project Fact Sheet
  Fact sheet for providers, from the On the CUSP: Stop CAUTI Implementation Guide
• Preventing CAUTI: Emergency Nursing Education
  CAUTI prevention training tool for emergency department nurses, from the Emergency Nurses Association. ENA requires log-in
• Script for Patient/Family Requests for Non-Medically Indicated Urinary Catheters [PDF – 1 page]
  Information to educate patients on urinary catheter risks and alternatives, from catheterout.org
• Preventing CAUTI: Emergency Nursing Education
  CAUTI prevention training tool for emergency department nurses, from the Emergency Nurses Association
• Script for Patient/Family Requests for Non-Medically Indicated Urinary Catheters [PDF – 358 KB]
  Information to educate patients on urinary catheter risks and alternatives, from catheterout.org
• Patient Education Brochure – What to Expect: Urinary Catheter [PDF – 738 KB]
  Patient education brochure focusing on catheter explanation and infection prevention, from the Alabama Department of Public Health
• Patient Education: Quick Facts About CAUTI [PDF – 112 KB]
  Fact sheet about CAUTI for patient education, from the Indiana State Department of Health

Example Resources

• Streamlined Evidence-Based RN Tool [PDF – 2 pages]
  Nurse-driven indwelling urinary catheter tool, including insertion checklist, from the American Nurses Association
• Let’s start using ANA’s CAUTI Tool – Video Editorial
  Video editorial describing ANA’s streamlined evidence-based RN CAUTI tool, from the American Nurses Association
• Urinary Catheter Insertion Checklist [PDF – 1 page]
  Checklist of best practices for Foley insertion, reprinted by the Pennsylvania Patient Safety Authority with permission from Doylestown Hospital
• Female Insertion Audit Checklist [PDF – 1 page]
  Checklist of critical behaviors for use in auditing insertion practices in FEMALE urinary catheterization, reprinted by the Pennsylvania Patient Safety Authority with permission from Doylestown Hospital
• Male Insertion Audit Checklist
  Checklist of critical behaviors for use in auditing insertion practices in MALE urinary catheterization, reprinted by the Pennsylvania Patient Safety Authority with permission from Doylestown Hospital
• CAUTI Prevention Training
  Training module for CAUTI prevention covering risks and infection prevention, from Sharp HealthCare
• Hand Hygiene Poster [PDF – 148 KB]
  Key moments for hand hygiene when caring for a patient with a urinary catheter, World Health Organization

Example Resources

• APIC Implementation Guide [PDF – 87 pages]
  Compilation of guidance from the Association for Professionals in Infection Control and Epidemiology (APIC) on topics including CAUTI surveillance and prevention initiatives. Contains an appendix with information on managing urinary catheters in spinal cord injury patients.
• Streamlined Evidence-Based RN Tool [PDF – 80 KB]
  Nurse-driven indwelling urinary catheter tool, including CDC-recommended maintenance procedures (Box 2), from the American Nurses Association
• Implementing a Nurse-Driven Protocol [PDF – 751 KB]
  Care practices assessment tool (Figure 1, p.18), from MedSurg Nursing
• Urinary Catheterization – Sample Policy [DOCX – 4 pages]
  Policy emphasizing appropriate insertion and maintenance practices for urinary catheters, from Association for Professionals in Infection Control and Epidemiology (APIC)
• Catheter Care Pocket Card [PDF – 40 KB]
  Tool for healthcare providers summarizing best practices for CAUTI prevention, from the On the CUSP: Stop CAUTI Implementation Guide
• CAUTI Prevention Training
  Training module for CAUTI prevention covering risks and infection prevention, from Sharp HealthCare
• Hospital Infection Control Worksheet [PDF – 1.73 KB]
  Data collection tool (Section 4.A., pg. 28-30) for assessment of aseptic insertion and appropriate maintenance for surveyors, from the Centers for Medicare & Medicaid Services (CMS)
• Urinary Tract Infection Bundle Compliance Audit Form
  Checklist to collect data on appropriate catheter maintenance during facility/unit audits, from St. Patrick Hospital and Health Science Center and IHI (log-in required).
• Hand Hygiene Poster [PDF – 148 KB]
  Key moments for hand hygiene when caring for a patient with a urinary catheter, World Health Organization
• Stop and Watch Early Warning Tool [PDF – 1 page]
  Early detection warning tool for non-medical personnel to report patient changes, can be used to identify patients exhibiting symptoms of a wide-range of conditions including infection, from Florida Atlantic University’s Interventions to Reduce Acute Care Transfers (INTERACT) Program

Example Resources

Nurse-Driven Removal

• Nurse-Driven Protocol for Catheter Removal
  Protocol for nurses to evaluate and discontinue urinary catheter use, from the Agency for Healthcare Research and Quality (AHRQ)
• Implementing a Nurse-Driven Protocol [PDF – 751 KB]
  Indwelling Urinary catheter removal protocol (Figure 2, p.19), from MedSurg Nursing
• Ex-Foley-Ate Slide Set [PPT – 6 MB]
  PowerPoint to promote urinary catheter best practices, from the Laurens County Healthcare System
• CDC Safe Healthcare Blog – Why So Many Foleys?
  Discussion of best practices for managing urinary catheters and reducing risk of CAUTI, guest author Wendy Kaler, MPH, CIC, Dignity Health
• Urinary Catheter Paper-based Removal Reminder [PDF – 162 KB]
  Worksheet to verify indication and remind providers to remove unnecessary indwelling urinary catheters, from the Virginia Department of Health
• Electronic Removal Reminder [PDF – 6 pages]
  Removal reminder for an electronic medical record, from catheterout.org

Example Resources

• Antibiotic Stewardship Driver Diagram and Change Package [PDF – 217 KB]
  A framework to reduce inappropriate antibiotic use in hospitals, including ideas for creating guidance on appropriate culturing (pg. 5), from the CDC and the Institute for Healthcare Improvement (IHI)
• Clinician Guide to Collecting Cultures
  Guidance for collecting various culture types from patients in preparation for testing, from the CDC and Hospital Corporation of America (HCA) Clinical Services Group
• Urine Culture Practices in the ICU
  Educational presentation that describes appropriate urine culture collection in the ICU, from the Agency for Healthcare Research and Quality (AHRQ)
• The Culture of Culturing: The Importance of Knowing When to Order Urine Cultures
  Educational presentation that describes when to order urine cultures in the long-term care setting, from Health Research and Educational Trust (HRET)