General catheter-associated urinary tract infection (CAUTI) prevention practices

Given the important clinical and economic consequences of catheter-associated urinary tract infection (CAUTI), researchers across the world have attempted various methods to prevent this common, costly, and  morbid patient safety problem. In this section, we summarize the evidence supporting the use of several practices  to prevent CAUTI. 

Between October 2008 and July 2010, at least 4 guidelines have been published from various organizations such as the Society for Healthcare Epidemiology of America (SHEA), the Centers for Disease Control and Prevention (CDC), the Association for Professionals in Infection Control (APIC), and the Infectious Diseases Society of America (IDSA).   Fortunately, members of our Ann Arbor VA Medical Center/University of Michigan Patient Safety Research group have been involved in the development of most of these guidelines.

While there are, of course, some differences between the different guidelines, there are several key areas of overlap. We provide below a concise summary of the recommended practices used to prevent CAUTI using the memory aide: “ABCDE

  • Adherence to general infection control principles (e.g., hand hygiene, surveillance and feedback, aseptic insertion, proper maintenance, education) is important
  • Bladder ultrasound may avoid indwelling catheterization
  • Condom catheters or other alternatives to an indwelling catheter such as intermittent catheterization should be considered in appropriate patients
  • Do not use the indwelling catheter unless you must!
  • Early removal of the catheter using a reminder, stop-order, or nurse-initiated removal protocol is warranted

Of the above, A, D, and E are the most important.