Preventing CAUTI in the ICU Setting

Module 4: Summary and Next Steps Facilitator Notes

Slide 1

AHRQ Safety Program for Reducing CAUTI in Hospitals  Preventing CAUTI in the ICU Setting Module 4: Summary and Next Steps  AHRQ Pub No. 15-0073-4-EF September 2015

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Slide 2

Summary of Module 1: CAUTI is a common and harmful healthcare-associated infection;  Evidence-based guidelines exist about catheter use; Mitigating CAUTI risk requires a team approach


You’ve now seen three modules on how to stop catheter-associated urinary tract infections, or CAUTI, in your intensive care unit, or ICU. In Module 1, you learned that hospital-acquired urinary tract infections impact almost 560,000 people every year in the United States alone. Of that number, almost 75 percent are catheter associated. Furthermore, of all healthcare-associated infections reported in the ICU, CAUTI accounts for nearly one-quarter of the infections.

You also learned in Module 1 that very clear, evidence-based guidelines exist about catheter use.  In addition, you learned about the influence of unit culture on practice change and the importance of a team approach to reduce CAUTI.

Slide 3

Summary of Module 2: Introduction to urinary catheter maintenance issues; Use of “teachable moments” to empower others in preventing CAUTI


Module 2 was about urinary catheter maintenance, and it featured the scenario of the nurse and the transporter. In it, you learned about aspects of catheter maintenance that can help prevent CAUTI, including bag placement and use of securement devices. You also learned about the power of teachable moments related to catheter use.

Slide 4

Summary of Module 3: Use of unit protocols to minimize catheter use; Importance of communication regarding urinary care plans


Module 3 featured the interaction between a day-shift nurse and night-shift nurse around an elderly patient with a catheter. It highlighted the use of unit protocols related to catheter use. Even more importantly, it emphasized the importance of communication. Being sure that you foster communication between nurses and doctors or between shifts will help you reduce and ultimately eliminate CAUTI.

Slide 5

Evidence-Based Guidelines and CAUTI Prevention: Circular flowchart showing how to prevent CAUTI.  1. Preventing unnecessary and improper placement. 2. Maintaining awareness and proper care of catheters. 3. Prompting catheter removal. 4. Preventing catheter replacement.


In the first three modules, you learned a great deal about catheter use and its impact on CAUTI. This graphic summarizes many of the points at which you can impact catheter use. Ultimately, breaking the catheter life cycle disrupts the progression toward CAUTI.

First, try not to use a catheter at all. Prevent unnecessary and improper placement.

Second, if a catheter is used, maintain awareness and proper care of catheters already in place.

Third, promote prompt catheter removal. You can do this through catheter reminders and stop-orders.

Fourth, prevent catheter replacement.

Slide 6

CAUTI Prevention, as Easy as ABCDE. Adherence to infection control principles (e.g., aseptic insertion, proper maintenance, education) is important; Bladder ultrasound may avoid indwelling catheterization; Condom or intermittent catheterization in appropriate patients; Do not use the indwelling catheter unless you must!     Early removal of the catheter using reminders or stop-orders appears warranted


When thinking about ways to break the catheter life cycle, consider these ABCDE prevention strategies:

  • A, for adhering to sound infection prevention principles when using catheters
  • B, for using equipment like the bladder ultrasound to assess patients’ ability to void adequately
  • C, for thinking about alternatives to an indwelling urinary catheter like condom or intermittent catheterization
  • D, meaning don’t use an indwelling catheter in the first place, if you can avoid it
  • E, for removing the catheter as early as possible

Slide 7

Your Challenge:  Promote a safety culture; Sustain progress; Limit the number of CAUTIs through:         Correct use (and not overuse) of urinary catheters; Observation; Communication


Obviously, we all want to care for our patients. We have to view preventing CAUTI as part of that responsibility. Promote a culture in your ICU that emphasizes constant vigilance around safety and ending CAUTI.

Once you have helped contribute to that safety culture, you will need to sustain your progress. Sometimes, sustaining progress can be the hardest part. As things become routine or part of the way of doing business, attention to them can slip, and you go back to old routines. Fight that urge and help your unit maintain its commitment to excellence.

Above all, remember that you can limit the number of CAUTIs directly, through a few key ways:

  • Use urinary catheters correctly. Avoid overuse.
  • Observe what happens in your unit and how catheters are used. Step in to make sure they are used correctly.
  • Communicate with others from both inside and outside your unit.

Return to CAUTI Toolkit Resources Page

Page last reviewed December 2017
Page originally created November 2015
Internet Citation: Preventing CAUTI in the ICU Setting. Content last reviewed December 2017. Agency for Healthcare Research and Quality, Rockville, MD.