AHRQ Safety Program for Long-Term Care: HAIs/CAUTI
Infections are a leading cause of illness and death in long-term care facilities.
These infections include catheter-associated urinary tract infections (CAUTIs).
|C||Catheter Removal||Think about catheters in any of your residents. Are the catheters really necessary?
Remove the catheter if there is no good indication for it. (See below.)
Every resident deserves a chance to be catheter-free and infection-free.
|A||Aseptic Insertion||Only trained personnel should insert catheters.
Use hand hygiene, and insert using aseptic technique.
Use the smallest catheter size that will allow good drainage for the resident.
Avoid contamination of the catheter.
Use catheter securement devices.
|U||Use Regular Assessments||Insert new urinary catheters only where there is a good indication. Incontinence is NOT an appropriate indication for an indwelling urinary catheter.
Consider alternatives to using a urinary catheter.
Use a bladder ultrasound to guide management.
Implement a process to see whether residents need catheters.
|T||Training for Catheter Care||Train staff, resident, and family.
Maintain a closed drainage system, and maintain unobstructed urine flow.
Use routine hygiene. Do not clean the periurethral area with antiseptics.
Routine catheter changes, urinalysis, and cultures are not required.
|I||Incontinence Care Planning||Consider alternatives to using a urinary catheter when developing individual resident care plans and behavioral interventions.
Consider timed and prompted voiding and use of a voiding diary.
Remember: No catheter means no CAUTI!
Appropriate Indications for an Indwelling Urinary Catheter
To assist in healing of open sacral or perineal wounds in incontinent residents.
For acute urinary retention or bladder outlet obstruction.
To improve comfort for end-of-life care if needed.
Source: Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee. Guideline for Prevention of Catheter-associated Urinary Tract Infections, 2009.
The AHRQ Safety Program for Long-Term Care: HAIs/CAUTI provides guides, tools and educational videos that will help you provide safer care for residents.