TAP Catheter-Associated Urinary Tract Infection (CAUTI) Implementation Guide: Links to Example Resources
Disclaimer: The links in the domains below are not mutually exclusive nor do they represent an exhaustive list of all the possible resources available. Furthermore, the links presented do not constitute an endorsement of these organizations or their programs by the Centers for Disease Control and Prevention (CDC) or the federal government, and none should be inferred.
See also CDC Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009
Engagement of Leadership, Champions, and Staff
- Engage the Senior Executive Module
Module with multiple tools focused on the roles and responsibilities of senior executives, including checklists for senior leaders and board members, from the Agency for Healthcare Research and Quality (AHRQ) - Toolkit for Reducing CAUTIs in Hospital Units
Implementation guide with tools designed to support implementation of evidence-based practices and elimination of CAUTIs, from AHRQ - CAUTI Cost Calculator
Tool to engage leadership that estimates facility costs due to CAUTI, from catheterout.org - Building Business Case for Infection Prevention Training Module
Training on developing a business case for infection prevention, including rationale, resources, and a plan for presenting to leadership, from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available - 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 Leader)
Presentation addressing the role of the nurse manager, from AHRQ - Roles and Responsibilities Table [PDF – 1 page]
Example implementation team roles and responsibilities, from Catheterout.org - Infection Prevention Champion
Informational webpage and accompanying PDF to aid partners in the identification and guidance of infection prevention champions, from the CDC - CUT CAUTI Bundle
Bundle of CAUTI resources on champions, training, appropriate catheter use, maintenance, removal, and evaluation of prevention interventions, from Minnesota Hospital Association - TeamSTEPPS 2.0
Training course for healthcare professionals designed to improve collaboration and communication within the healthcare institution, from AHRQ - Strategies for Preventing HAIs Training Module
Training on engaging leadership, physicians, nurses, and environmental services managers in infection prevention, from HRET and CDC’s STRIVE Infection Control Training. CE available - CAUTI Guide to Patient Safety (GPS) Tool [PDF – 27 pages]
Tool for examining and improving CAUTI prevention resources and activities, including champions (pgs. 7-8, 14-15) and leadership support (pg. 16), from catheterout.org
Tools for the CAUTI Workgroup
- Toolkit for Reducing CAUTIs in Hospital Units
Implementation guide with tools designed to support implementation of evidence-based practices and elimination of CAUTIs, from the Agency for Healthcare Research and Quality (AHRQ) - APIC Implementation Guide
Compilation of guidance on topics including CAUTI surveillance and prevention initiatives, as well as information on managing urinary catheters in spinal cord injury patients, from the Association for Professionals in Infection Control and Epidemiology (APIC). To access tool, click ‘download’ and enter email, no account or membership required - Strategies to Prevent CAUTI in Acute Care Hospitals: 2014 Update [PDF – 17 pages]
Practical recommendations for CAUTI prevention for acute care hospitals, from The Society for Healthcare Epidemiology of America (SHEA) - Toolkit for Preventing CLABSI and CAUTI in ICUs
Toolkit with resources and strategies focusing on prevention of CLABSI and CAUTI in ICUs, including an ICU Assessment, Response Guide and Action Plan Template, from the Agency for Healthcare Research and Quality (AHRQ) - CUT CAUTI Bundle [DOCX – 3 pages]
Bundle of CAUTI resources on champions, training, appropriate catheter use, maintenance, removal, and evaluation of prevention interventions, from Minnesota Hospital Association - Building Business Case for Infection Prevention Training Module
Training on developing a business case for infection prevention, including rationale, resources, and a plan for presenting to leadership, from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available
Staff Training and Competency/Skills Assessments
- Prevention Strategies for CAUTI Training Modules
Training modules on CAUTI prevention, including information on appropriate use, insertion, maintenance, and removal of urinary catheters, along with urine culture stewardship, from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available if all 7 modules completed - Competency Based Training, Audits and Feedback Modules
Training modules covering the design of competency-based training (Module CBT 101), use of audits, and giving effective feedback, from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available if all 3 modules completed - Competency Check versus Observational Audit [PDF – 2 pages]
Fact sheet describing the differences between competency/skills assessments and observational audits, from the Agency for Healthcare Research and Quality (AHRQ) - 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 (ANA) - Bladder Scan Policy and Checklist
Policy for use of bladder scanners, from the Agency for Healthcare Research and Quality (AHRQ) - Appropriate Urinary Catheter Use and Management Nursing Education [PDF – 54 pages]
PowerPoint slide set on appropriate urinary catheter use and management, from catheterout.org - Emergency Nurses Association (ENA) presents CAUTI [PDF – 54 pages]
Transcript of a presentation by the Emergency Nurses Association (ENA) on how to reduce CAUTIs, from AHRQ - Preventing Urinary Tract Infections With a Two-Person Catheter Insertion Procedure
Article with description of a two-person insertion procedure and the resulting reduction of CAUTI, from Nursing - Female Urethral Catheterization
Instructional video discussing indications for catheterization, equipment, and methods for insertion on female patients, from the New England Journal of Medicine (NEJM) - 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 Urethral Catheterization
Instructional video discussing indications for catheterization, equipment, and methods for insertion on male patients, from NEJM - 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
Routine Audits and Feedback
- Streamlined Evidence-Based RN Tool [PDF – 2 pages]
Nurse-driven indwelling urinary catheter tool, including insertion checklist, from the American Nurses Association - 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 – 8 pages]
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) - Indwelling Urinary Catheter Maintenance Practices Adherence Monitoring Tool [PDF – 2 pages]
Adherence monitoring tool for urinary catheter maintenance practices from the California Department of Public Health (CDPH) - Competency Check versus Observational Audit [PDF – 2 pages]
Fact sheet describing the differences between competency/skills assessments and observational audits, from the Agency for Healthcare Research and Quality (AHRQ) - QUOTS: Urinary Catheter Observation [PDF – 2 pages]
Quick Observation Tools (QUOTS) Example Observation form for proper catheter maintenance, from CDC and the Association for Professionals in Infection Control and Epidemiology (APIC) - Providing Timely and Effective Feedback: Tips and Scripts [PDF – 7 pages]
Informational packet that provides tips on how to deliver effective feedback with scripted examples of common scenarios that may occur when observing hand hygiene, personal protective equipment use, and contact precautions compliance, from CDC - Having Difficult Conversations About Preventing Infections in the ICU
Video highlighting the importance of speaking up to prevent infections in the ICU, including examples of how team members can have difficult conversations, from AHRQ - Competency Based Training, Audits and Feedback Modules
Training modules covering the design of competency-based training, use of audits (Module CBT 102), and giving effective feedback (Module CBT 103), from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available if all 3 modules completed
Example Resources
- Guideline for Prevention of CAUTI, 2009 [PDF – 61 pages]
Appropriate indications provided in Table 2 (pg. 11), from the CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC) - The Ann Arbor Criteria for Appropriate Urinary Catheter Use [PDF – 34 pages]
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 - Appropriate Urinary Catheter Placement in the Emergency Department
Online course for urinary catheter placement in the emergency department, from the Emergency Nurses Association (ENA) Log-in Required - Bladder Scan Policy and Checklist
Policy for use of bladder scanners, from the Agency for Healthcare Research and Quality (AHRQ) - 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 – 8 pages]
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 - Prevention Strategies for CAUTI Training Modules- Appropriate Use and Alternatives
Training modules on CAUTI prevention, including information on appropriate use of indwelling urinary catheters (Module CAUTI 102) and alternatives to indwelling urinary catheters (Module CAUTI 103), from HRET and CDC’s STRIVE Infection Control Training. CE available if all 7 modules completed - CAUTI Prevention Brochure
Brochure for providers summarizing indications for catheter use, from AHRQ - Strategies to Prevent CAUTI in Acute Care Hospitals: 2014 Update [PDF – 17 pages]
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 AHRQ
Patient and Family Engagement
- 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 - 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 - Patient and Family Engagement Training Module
Training on engaging patients and families in infection prevention, from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available
Example Resources
- Streamlined Evidence-Based RN Tool [PDF – 2 pages]
Nurse-driven indwelling urinary catheter tool, including insertion checklist, from the American Nurses Association (ANA) - Let’s start using ANA’s CAUTI Tool – Video Editorial
Video editorial describing ANA’s streamlined evidence-based RN CAUTI tool, from ANA - 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 - Female Urethral Catheterization
Instructional video discussing indications for catheterization, equipment, and methods for insertion on female patients, from the New England Journal of Medicine (NEJM) - 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 - Male Urethral Catheterization
Instructional video discussing indications for catheterization, equipment, and methods for insertion on male patients, from NEJM - CAUTI Prevention Training [PDF – 45 pages]
Training module for CAUTI prevention covering risks and infection prevention, from Sharp HealthCare - Hand Hygiene Poster [PDF – 1 page]
Key moments for hand hygiene when caring for a patient with a urinary catheter, from World Health Organization (WHO) - Prevention Strategies for CAUTI Training Modules- Proper Insertion
Training modules on CAUTI prevention, including information on proper indwelling urinary catheter insertion (Module CAUTI 104), from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available if all 7 modules completed
Example Resources
- Streamlined Evidence-Based RN Tool [PDF – 2 pages]
Nurse-driven indwelling urinary catheter tool, including CDC-recommended maintenance procedures (Box 2), from the American Nurses Association - Implementing a Nurse-Driven Protocol [PDF – 8 pages]
Foley catheter practice survey tool (Figure 1, pg. 18), from MedSurg Nursing - Urinary Catheterization – Sample Policy [DOCX – 4 pages]
Policy emphasizing appropriate insertion and maintenance practices for urinary catheters, from the Agency for Healthcare Research and Quality (AHRQ) - Catheter Care Pocket Card [DOCX – 1 page]
Tool for healthcare providers summarizing best practices for CAUTI prevention, from AHRQ - CAUTI Prevention Training [PDF – 45 pages]
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) - Hand Hygiene Poster [PDF – 1 page]
Key moments for hand hygiene when caring for a patient with a urinary catheter, from World Health Organization (WHO) - Indwelling Urinary Catheter Maintenance Practices Adherence Monitoring Tool [PDF – 2 pages]
Adherence monitoring tool for urinary catheter maintenance practices from the California Department of Public Health (CDPH) - QUOTS: Urinary Catheter Observation [PDF – 2 pages]
Quick Observation Tools (QUOTS) Example Observation form for proper catheter maintenance, from CDC and APIC - Prevention Strategies for CAUTI Training Modules- Maintenance
Training modules on CAUTI prevention, including information on indwelling urinary catheter maintenance (Module CAUTI 104), from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available if all 7 modules completed
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 – 8 pages]
Indwelling Urinary catheter removal protocol (Figure 2, p.19), from MedSurg Nursing - Ex-Foley-Ate Slide Set
PowerPoint to promote urinary catheter best practices, from the Laurens County Healthcare System - 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 - Foley Catheter Daily Tracking Sheet
Daily review of Foley necessity, from Atlantic Quality Innovation Network - CAUTI Guide to Patient Safety (GPS) Tool [PDF – 27 pages]
Tool for examining and improving CAUTI prevention resources and activities, including practices related to timely removal of urinary catheters (pg 9-13), from catheterout.org - Prevention Strategies for CAUTI Training Modules- Removal
Training modules on CAUTI prevention, including information on indwelling urinary catheter removal (Module CAUTI 102), from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available if all 7 modules completed
Example Resources
- Urine Culture Stewardship in Hospitalized Patients
Background and guidance for designing and implementing a urine culture stewardship program for hospitalized patients with indwelling urinary catheters, including detailed content on the 4 elements of designing a program: survey, structure, strategize and sustain (click individual links under contents for more information), from the CDC - Antibiotic Stewardship Driver Diagram and Change Package [PDF – 12 pages]
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) - The Culture of Culturing: The Importance of Knowing When to Order Urine Cultures [PPT – 13 pages]
Educational ppresentation that describes when to order urine cultures in the long-term care setting, from the Agency for Healthcare Research and Quality (AHRQ) - 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 - Prevention Strategies for CAUTI Training Modules- Urine Culture Stewardship- Urine Culture Stewardship
Training modules on CAUTI prevention, including information on urine culture stewardship (Module CAUTI 105), from Health Research & Educational Trust (HRET) and CDC’s STRIVE Infection Control Training. CE available if all 7 modules completed - Toolkit to Enhance Nursing and Antibiotic Stewardship Partnership- Urine Culture Resources
Comprehensive toolkit to enhance nursing antibiotic stewardship, including urine culture educational resources for nurses and an example urine culture algorithm, from Johns Hopkins University - Kicking CAUTI Campaign: Achieving Clinical Impact through Interdisciplinary Teamwork
Presentation describing campaign to improve diagnostic stewardship for CAUTI, video and PDF slides available, from the US Department of Veterans Affairs
Last Reviewed: March 13, 2023