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Healthcare-Associated Infections

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Prevention ÎAppropriate management of indwelling catheters > Properly secure indwelling catheters after insertion to prevent movement and urethral traction (A-III). > Maintain a sterile, continuously closed drainage system (A-I). > Do not disconnect the catheter and drainage tube unless the catheter must be irrigated (A-I). > Replace the collecting system by use of aseptic technique and after disinfecting the catheter-tubing junction when breaks in aseptic technique, disconnection, or leakage occur (B-III). > For examination of fresh urine, collect a small sample by aspirating urine from the sampling port with a sterile needle and syringe after cleansing the port with disinfectant (A-III). > Obtain larger volumes of urine for special analyses aseptically from the drainage bag (A-III). > Maintain unobstructed urine flow (A-II). > Empty the collecting bag regularly, using a separate collecting container for each patient, and avoid allowing the draining spigot to touch the collecting container (A-II). > Keep the collecting bag below the level of the bladder at all times (A-III). > Cleaning the meatal area with antiseptic solutions is unnecessary; routine hygiene is appropriate (A-I). Special approaches for the prevention of CAUTI** ÎPerform a CAUTI risk assessment. ÎImplement an organization-wide program to identify and remove catheters that are no longer necessary, using one or more methods documented to be effective (A-II). ÎDevelop a protocol for management of postoperative urinary retention, including nurse-directed use of intermittent catheterization and use of bladder scanners (B-I). ÎEstablish a system for analyzing and reporting data on catheter use and adverse events from catheter use (B-III). Approaches that should CAUTI prevention ÎDo ÎDo Î be considered a routine part of screen for asymptomatic bacteriuria in catheterized patients (A-II). treat asymptomatic bacteriuria in catheterized patients except before invasive urologic procedures (A-I). catheter irrigation (A-I). ÎDo ÎDo use systemic antimicrobials routinely as prophylaxis (A-II). change catheters routinely (A-III). N OT N OT N OT AV N O I D OT N OT

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