Preventing Catheter-Associated
Urinary Tract Infections (CAUTIs)
within the Hospital Setting
ANGELA VOTO
Learning Objectives
State the relationship between aseptic technique and
the prevention of CAUTIs
Explain the steps involved in the insertion of a catheter
using aseptic technique
Identify and state the various methods to prevent
CAUTIs
Catheter-Associated Urinary Tract Infections
UTIs are the most common nosocomial infection
UTIs account for up to 40% of infections within the
acute care setting
80% of UTIs are associated with the presence of a catheter
CAUTIs are associated with increased morbidity and
mortality
CAUTIs increase the out of pocket cost of hospitals
Increase cost $400 million per year nationally
Extend length of stay 2-4 days
CAUTIs create unnecessary antimicrobial use
Statistics in Massachusetts
Indwelling Urinary Catheter
1 in 4 patients receives an
indwelling catheter
Up to 50% of catheters are placed
unnecessarily
A patient should be catheterized
only if necessary
If an indwelling catheter cannot
be avoided, a closed drainage
system should be used.
Questions to Ask Before Insertion.
What is the indication for inserting a catheter?
Are there any alternative options that can be tried?
What is best for the specific patient?
What should be documented?
Indication, insertion/removal date, output measurements
How soon until the catheter can/should be removed?
Prolonged catheterization is a major risk of infection
Appropriate Indications
Post Operative Indications
Peri-operatively and 24 hrs post operation
After urological, gynecological, or peri/rectal surgery
Urethral trauma or post-op radical prostatectomy
Other indications
Urinary retention or bladder outlet obstruction
Urinary output monitoring
Gross hematuria/risk for clotting
Epidural in place
Prolonged immobilization required
Stage 3-4 sacral, perineal, or truncal pressure ulcer
Comfort measures, palliative care for terminally ill patient
Patients at high risk for CAUTIs
High Risk Population
Women
Elderly
Debilitated
Malnourished
Chronically ill
Immunosupressed
Diabetic
S/S: cloudy malodorous urine, hematuria, fever, chills,
anorexia, confusion, and malaise
Interventions: obtain UA and C+S
Catheterization Kit
Includes:
1.
Sterile Gloves
2.
Sterile Drape
3.
Closed Catheter
System with
Drainage Bag
4.
10 mL Flush Syringe
5.
Betadine
6.
Cotton Swabs
7.
Forceps
8.
Water-Soluble
Lubricant
Inserting an Indwelling Catheter
Inserting a Urinary Catheter
1.
2.
3.
4.
5.
6.
Gather equipment and explain procedure to patient
Place patient in supine position with legs abducted
Open catheterization kit and prepare sterile field
Place sterile drape over perineal area; apply sterile gloves
Check balloon patency with 10mL syringe flush
Apply lubricant to distal portion of the catheter
Inserting a Urinary Catheter
7.
8.
9.
10.
11.
Open packet of betadine and pour over cotton swabs
For females, spread labia and for males, hold shaft of penis
Take hold of forceps, cleanse peri-urethral mucosa with
betadine soaked cotton swabs
Grasp catheter holding 2-3 inches from the tip
Locate meatus and insert catheter 1-2 inches beyond where
urine is noted.
Inserting a Urinary Catheter
12. Inflate balloon with 10mL syringe flush
13. Pull catheter until balloon is against bladder
14. Secure catheter to patients thigh using leg band
15. Place drainage bag below patients bladder
16. Evaluate drainage function and assess
amount, color, and odor of urine
17. Document catheter size, amount of
fluid in balloon, and patients response
Nursing Interventions
Use aseptic technique during insertion
Use the smallest size catheter possible
Inspect urine color, odor, amount, and consistency
Empty the collection bag at least Q8 hours
Perform perineal care with soap and water 2x/day+
Obtain urine sample per manufacturers instructions
Monitor vital signs
Preventing Infection in a Catheterized Patient
Use pre-assembled, sterile,
closed drainage system
Perform proper hand hygiene
Ensure free flow of urine
Do not irrigate the catheter
Obtain UA and C+S
Monitor voiding upon removal
Thank you!
DOES ANYONE
HAVE ANY
QUESTIONS??
Works Cited
Catheter-associated Urinary Tract Infections. (2012, May 17). Retrieved October 14, 2014, from
http://www.cdc.gov/HAI/ca_uti/uti.html
Nursings role in urinary catheter insertion, removal, and routine care (Urinary Catheter Care)
http://www.atitesting.com/ati_next_gen/skillsmodules/content/urinary-cathetercare/research/Nursing-role.html
Bell, L. (2011, November 1). Catheter-Associated Urinary Tract Infections. Retrieved October 14, 2014,
from http://www.aacn.org/WD/practice/docs/practicealerts/catheter-associated-uti-practicealert.pdf
Brunner, L. S., Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner and Suddarth's
textbook of medical-surgical nursing. (12 ed., Vol. 1). Hubsta Ltd.
Greene, L., & Marx, J. (2008, January 1). Guide to the Elimination of Catheter-Associated Urinary Tract
Infections. Retrieved October 15, 2014, from
http://www.apic.org/Resource_/EliminationGuideForm/c0790db8-2aca-4179-a7ae676c27592de2/File/APIC-CAUTI-Guide.pdf
PHOTOS
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http://images.medicinenet.com/images/slideshow/uti_s4_urine_cup.jpg
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