Table 1. Recommendations to Prevent CAUTI
6. Implement a system for documenting the following in the patient record: physician
order for catheter placement, indications for catheter insertion, date and time of
catheter insertion, name of individual who inserted catheter, nursing documentation of
placement, daily presence of a catheter and maintenance care tasks, and date and time
of catheter removal. Record criteria for removal and justification for continued use. (L)
a. Record in a standard format for data collection and quality improvement purposes
and keep accessible documentation of catheter placement (including indication) and
removal.
b. If available, utilize electronic documentation that is searchable.
c. Consider nurse-driven urinary catheter removal protocols for first trial of void
without an indwelling catheter when the indication for placement has resolved (see
Essential Practices, 3).
7. Ensure that sufficiently trained HCP and technolog y resources are available to support
surveillance for catheter use and outcomes. (L)
8. Perform surveillance for CAUTI if indicated based on facility risk assessment or
regulatory requirements. (L)
9. Standardize urine culturing by adapting an institutional protocol for appropriate
indications for urine cultures in patients with and without indwelling catheters.
Consider incorporating these indications into the EMR, and review indications for
ordering urine cultures in CAUTI risk assessment. (L)
Education and training
1. Educate HCP involved in the insertion, care, and maintenance of urinary catheters
about CAUTI prevention, including alternatives to indwelling catheters, and
procedures for catheter insertion, management, and removal. (L)
2. Assess healthcare professional competency in catheter use, catheter care, and
maintenance. (L)
3. Educate HCP about the importance of urine-culture stewardship and provide
indications for urine cultures. (L)
a. Consider requiring clinicians to identify an appropriate indication for urine
culturing when placing an order for a urine culture.
4. Provide training on appropriate collection of urine. Specimens should be collected and
arrive at the microbiolog y lab as soon as possible, preferably within an hour. If delay in
transport to the laboratory is expected, samples should be refrigerated (no more than
24 hours) or collected in preservative urine transport tubes. (L)
5. Train clinicians to consider other methods for bladder management such as
intermittent catheterization, or external male or female collection devices, when
appropriate before placing an indwelling urethral catheter. (L)
6. Share data in a timely fashion and report results to appropriate stakeholders. (L)
(cont'd)
