Catheter-associated urinary tract infections (CAUTIs) are among the most common types of healthcare-associated infections. Most cases of CAUTI are preventable. Since October 2008, the Centers for Medicare & Medicaid Services no longer reimburses costs associated with hospital-acquired CAUTI.
Following are AHRQ tools, research, and resources related to reducing CAUTI.
This toolkit helps hospitals prevent CAUTI in patients and improve safety culture at the unit level by implementing concepts from the Comprehensive Unit-based Safety Program (CUSP). The toolkit has evidence-based, practical resources that reflect the real-world experiences of frontline providers and researchers who participated in a national implementation project to reduce CAUTIs.
This toolkit helps long-term care facilities reduce CAUTI and improve practices to prevent HAIs. Based on principles and methods from CUSP, the toolkit includes instructional materials and resources in infection prevention best practices, resident and family engagement, quality improvement, and sustainability to guide a facility through implementing an improvement project to reduce HAIs. The toolkit's resources were used by facilities that participated in the AHRQ Safety Program for Long-Term Care: HAIs/CAUTI, which successfully reduced CAUTI rates.
This 2013 report provides preliminary outcome data from a six-cohort collaborative that used CUSP and associated tools to prevent CAUTIs. The early data show a decrease in the overall rate of CAUTI, with a more striking decrease in non-intensive care unit i(ICU) settings than in ICU settings.
Rates of CAUTI dropped by 54 percent across more than 400 long-term care facilities that participated in an AHRQ-funded project.
The study authors examined data from 926 hospital units (including ICUs and non-ICUs) that participated in the early stages of the 4-year AHRQ CUSP project. CAUTI rates decreased by 32 percent in non-ICUs, from 2.28 to 1.54 infections per 1,000 days of catheter use. Rates of CAUTIs and catheter use in participating ICUs were unchanged.
This study assessed the impact of the 2008 Centers for Medicare & Medicaid Services policy to not reimburse hospitals for costs associated with certain preventable complications, including CAUTI. It found very few cases where payment was denied due to a CAUTI. The incidence of CAUTI was much lower than expected, most likely due to inaccuracies in the billing claims databases used to identify CAUTI.
The authors describe their experience in developing, implementing, and analyzing a retrospective, comprehensive medical record review regarding urinary catheter use and identification of urinary tract infections as CAUTIs. The authors share the results of urinary catheter use measures to illustrate the complexity in identifying catheter use in medical records that are being used to generate quality measures for comparing hospitals.
Researchers at the University of Colorado partnered with the Nurses Improving Care of Healthsystem Elders (NICHE) program to create the STOP CAUTI Workgroup to implement and test the impact of electronic surveillance of indwelling urinary catheter use and CAUTI rates. Recruited from among 245 NICHE member hospitals, 20 hospitals completed all steps required to participate in the cluster-randomized controlled trial of audit and feedback in the reduction of CAUTI among hospitalized patients. This paper details the engage, educate, and establish stages of the project.
AHRQ's PSNet offers research and resources on reducing CAUTI.