Clinical Safety: Preventing Catheter-associated Urinary Tract Infections (CAUTIs)

Why it matters

• CAUTIs are one of the most common HAIs.
• About 75% of UTIs developed in hospitals are associated with a urinary catheter.
• 15-25% of hospitalized patients receive urinary catheters during their hospital stay.
• CAUTIs are associated with increased morbidity, mortality, healthcare costs and length of stay.
• They are preventable.

Background

A urinary tract infection (UTI) is an infection that involves any of the organs or structures of the urinary tract, (e.g., kidneys, ureters, bladder and urethra).

A CAUTI occurs when germs (usually bacteria) enter the urinary tract through the urinary catheter and cause infection.

Recommendations

• Only use urinary catheters when needed.
• Place catheters using proper germ-free techniques with sterile equipment.
• Maintain the catheter's closed sterile drainage system.
• Remove catheters as soon as patients no longer need them. Prolonged use is the most important risk factor for CAUTIs.

Healthcare facilities should follow the 2009 CDC Guideline for Prevention of Catheter-associated Urinary Tract Infections. The guideline emphasizes the proper use, insertion, and maintenance of urinary catheters in different healthcare settings. It also presents effective quality improvement programs that healthcare facilities can use to prevent CAUTIs.

Acute care hospitals should follow Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals: 2014 Update.

Assessment tools

Facilities can monitor CAUTI rates and assess the effectiveness of prevention efforts through CDC's National Healthcare Safety Network (NHSN).

Facilities can also identify infection prevention gaps and launch tailored interventions to reduce CAUTI risk with the Targeted Assessment for Prevention (TAP) Strategy.

Additional resources:

• IDSA Guidelines
• APIC Guide to the Elimination of CAUTI