No More CAUTI: Preventing Catheter-Associated Urinary Tract Infections (May 5, 2015)

Slide Presentation

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No More CAUTI - Preventing Catheter-Associated Urinary Tract Infections

Elizabeth Mizerek, MSN, RN, CEN, CPEN, FN-CSA
Assistant Professor of Nursing
Mercer County Community College

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Learning Objectives

  • Define the impact of CAUTI
  • Describe decision making scenarios around catheter insertion indications
  • Explain policies, procedures and insertion competencies

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Insertion Indications

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Appropriate Catheter Indications

  • Urinary retentionor urinary flow obstructions

Image: Health professional starting catheter procedure on a patient.

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Appropriate Catheter Indication

  • Monitoring fluids in critically ill patients

Image: Health professionals surrounding patient.

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Appropriate Catheter Indications

  • Healing of significant sacral of perineal wounds

Image: Image of a patient with serious perineal wounds.

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Appropriate Catheter Indications

  • Improving comfort at end of life.

Image: Photo of woman at bedside of patient holding hands with patient.

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Appropriate Catheter Indications

  • Selected perioperative use

Image: X-ray showing a hip with 2 fractures in it.

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Appropriate Catheter Indication

  • Immobilization due to trauma

Image: Photo showing a bunch of immobilization boards used during emergency transport.

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Alternative to Indwelling Catheter

  • Bladder scanner to assess volume of urine in bladder
  • Straight catheter
  • Condom catheter for men

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Inappropriate Catheter Indications

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Inappropriate Catheter Indications

  • Incontinence

Catheters do not protect skin

Image: Legs of a man with the pants pulled down to the shoes.

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Inappropriate Catheter Indications

  • Morbid obesity

Image: Back of a morbidly obese person.

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Inappropriate Catheter Indications

  • Limited mobility or debility

Catheters do not prevent falls

Image: Hand pushing a wheelchair wheel.

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Inappropriate Catheter Indications

  • Dementia or confusion

Catheters do not prevent falls

Image: Dog with a question mark over its' head.

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Inappropriate Catheter Indications

  • Monitoring of fluids in non-critically ill patients

You can monitor output many ways

Image: Bedpan.

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Inappropriate Catheter Indications

  • Urine specimen collection

Straight cath!

Image: Hand holding a filled urine specimen container.

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Inappropriate Catheter Indications

  • Patient of family request

Educate patient and family on catheter risks

Image: Hand holding a nurse call bell and the outlet with a plug.

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Inappropriate Catheter Indications

  • Staff convenience

Catheters don't save time

Image: Health professional filling out information.

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Decision Making Scenarios

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Catheter or No Catheter?

Acute stroke patient with left sided weakness who is going to receive IV t-PA.

Image: Acute stroke patient with left-sided weakness.

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Catheter or No Catheter?

Family requests foley for patient….and provider orders it.

Images: Photo of woman talking to a doctor, and a doctor looking angry and demanding.

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Catheter or No Catheter?

Hip fracture going to OR... eventually

Image: Elderly bedridden female patient.

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Catheter or No Catheter?

Elderly, confused, non-ambulatory patient

Image: Elderly bedridden female patient.

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Catheter or No Catheter?

Critically ill ICU patient

Image: Trauma patient being treated by a number of health professionals.

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Catheter or No Catheter?

Patient unable to provide clean catch urine

Image: Hand holding a filled urine specimen container.

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Catheter or No Catheter?

Acute CHF receiving lasix on bi-pap

Image: Photo of patient with a bi-pap machine

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Demonstrated Competency

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Education

  • When, where and how to nurses learn to place indwelling urinary catheters?
  • Does the learning environment match the practice environment?

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Image: Simulation dummy patient

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Image: Simulation dummy patient

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Image: Close-up image of crotch area of simulation dummy showing the area as "soiled".

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Image: Close-up image of crotch area of simulation dummy showing the area as "soiled".

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Image: Students practicing urinary catheter insertions using simulation dummy.

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Some Additional Thoughts...

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Teamwork

  • Shared mental model – trained nurses and techs together
  • Teamwork to facilitate placement
  • Empowered all staff to speak up when breach of sterile technique noted – patient safety!

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Conclusion

  • A indwelling urinary catheter is not a life-saving procedure
  • Think, slow down, appropriate technique
  • Safe practice, safe care!

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Thank you!

Questions?

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Funding

Prepared by the Health Research & Educational Trust of the American Hospital Association with contract funding provided by the Agency for Healthcare Research and Quality through the contract, “National Implementation of Comprehensive Unit-based Safety Program (CUSP) to Reduce Catheter-Associated Urinary Tract Infection (CAUTI), project number HHSA290201000025I/HHSA29032001T, Task Order #1.”

Return to CAUTI Toolkit Information for Specialty Audiences Page

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page last reviewed December 2017
Page originally created November 2015
Internet Citation: No More CAUTI: Preventing Catheter-Associated Urinary Tract Infections (May 5, 2015). Content last reviewed December 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/no-more-cauti-slides.html