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) Toolkitexternal icon
  Curriculum focused on the role and responsibilities of senior executives, from the Agency for Healthcare Research and Quality (AHRQ)
• CAUTI Cost Calculatorexternal icon
  Tool to engage leadership that estimates facility costs due to CAUTI, from catheterout.org
• Implementation Team Roles and Responsibilities pdf icon[PDF – 1 page]external icon
  Summary of recommended personnel to engage for CAUTI reduction efforts, from catheterout.org
• CUSP Board Checklistexternal icon
  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 Providersexternal icon
  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)external icon
  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)external icon
  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 icon[PDF – 2 MB]external icon
  Training module for CAUTI prevention, covering CAUTI risks and prevention, from Sharp HealthCare
• Streamlined Evidence-Based RN Tool pdf icon[PDF – 2 pages]external icon
  Nurse-driven indwelling urinary catheter tool, including insertion checklist and bladder scan protocol, from the American Nurses Association
• Bladder Scan Policy and Checklistexternal icon
  Policy for use of bladder scanners, from the On the CUSP: Stop CAUTI Implementation Guide
• Appropriate Urinary Catheter Use and Management Nursing Education pdf icon[PDF – 54 pages]external icon
  PowerPoint slide set on appropriate urinary catheter use and management, from catheterout.org

Routine Audits

• Appropriate Urinary Catheter Placement in the EDexternal icon
  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 icon[PDF – 1.76 MB]external icon
  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 icon[PDF – 80 KB]external icon
  Nurse-driven indwelling urinary catheter tool, including insertion checklist, from the American Nurses Association
• Urinary Catheter Insertion Checklist pdf icon[PDF – 1 page]external icon
  Checklist of best practices for Foley insertion, reprinted by the Pennsylvania Patient Safety Authority with permission from Doylestown Hospital
• Female Insertion Audit Checklist pdf icon[PDF – 2 pages]external icon
  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 Checklistexternal icon
  Checklist of critical behaviors for useexternal icon 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 icon[PDF – 751 KB]external icon
  Foley Catheter Practice Survey Tool (Figure 1, p. 18), from MedSurg Nursing
• Hospital Infection Control Worksheet pdf icon[PDF – 1.73 MB]external icon
  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 Formexternal icon
  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 Useexternal icon
  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 Checklistexternal icon
  Policy for use of bladder scanners, from the On the CUSP: Stop CAUTI Implementation Guide
• Streamlined Evidence-Based RN Tool pdf icon[PDF – 2 pages]external icon
  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 icon[PDF – 751 KBexternal icon
  Evaluation of nurse-driven catheter removal protocols in the acute care setting, from MedSurg Nursing
• Policy/Procedure for Perineal Care for the Incontinent Patient word icon[DOC – 52 KB]external icon
  Perineal care procedures as alternatives to catheterization for incontinent patients, from the Virginia Department of Health
• Catheterization Alternatives Flyer pdf icon[PDF – 1.44 MB]external icon
  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 Brochureexternal icon
  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 Updatepdf iconexternal icon
  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 icon[PDF – 1 page]external icon
  Catheter removal reminder tools for use by physicians and nurses, from catheterout.org
• Urinary Catheter Project Fact Sheetexternal icon
  Fact sheet for providers, from the On the CUSP: Stop CAUTI Implementation Guide
• Preventing CAUTI: Emergency Nursing Educationexternal icon
  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 icon[PDF – 1 page]external icon
  Information to educate patients on urinary catheter risks and alternatives, from catheterout.org
• Preventing CAUTI: Emergency Nursing Educationexternal icon
  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 icon[PDF – 358 KB]external icon
  Information to educate patients on urinary catheter risks and alternatives, from catheterout.org
• Patient Education Brochure – What to Expect: Urinary Catheter pdf icon[PDF – 738 KB]external icon
  Patient education brochure focusing on catheter explanation and infection prevention, from the Alabama Department of Public Health
• Patient Education: Quick Facts About CAUTI pdf icon[PDF – 112 KB]external icon
  Fact sheet about CAUTI for patient education, from the Indiana State Department of Health

Example Resources

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

Example Resources

• APIC Implementation Guide pdf icon[PDF – 87 pages]external icon
  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 icon[PDF – 80 KB]external icon
  Nurse-driven indwelling urinary catheter tool, including CDC-recommended maintenance procedures (Box 2), from the American Nurses Association
• Implementing a Nurse-Driven Protocol pdf icon[PDF – 751 KB]external icon
  Care practices assessment tool (Figure 1, p.18), from MedSurg Nursing
• Urinary Catheterization – Sample Policy word icon[DOCX – 4 pages]external icon
  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 icon[PDF – 40 KB]external icon
  Tool for healthcare providers summarizing best practices for CAUTI prevention, from the On the CUSP: Stop CAUTI Implementation Guide
• CAUTI Prevention Trainingexternal icon
  Training module for CAUTI prevention covering risks and infection prevention, from Sharp HealthCare
• Hospital Infection Control Worksheet pdf icon[PDF – 1.73 KB]external icon
  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 Formexternal icon
  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 icon[PDF – 148 KB]external icon
  Key moments for hand hygiene when caring for a patient with a urinary catheter, World Health Organization
• Stop and Watch Early Warning Tool pdf icon[PDF – 1 page]external icon
  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 Removalexternal icon
  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 icon[PDF – 751 KB]external icon
  Indwelling Urinary catheter removal protocol (Figure 2, p.19), from MedSurg Nursing
• Ex-Foley-Ate Slide Set ppt icon[PPT – 6 MB]external icon
  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 icon[PDF – 162 KB]external icon
  Worksheet to verify indication and remind providers to remove unnecessary indwelling urinary catheters, from the Virginia Department of Health
• Electronic Removal Reminder pdf icon[PDF – 6 pages]external icon
  Removal reminder for an electronic medical record, from catheterout.org

Example Resources

• Antibiotic Stewardship Driver Diagram and Change Package pdf icon[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 ICUexternal icon
  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 Culturesppt iconexternal icon
  Educational presentation that describes when to order urine cultures in the long-term care setting, from Health Research and Educational Trust (HRET)