Table 1. Recommendations to Prevent CAUTI
Insertion of indwelling catheters
1. Insert urinary catheters only when necessary for patient care and leave in place only as
long as indications remain. (M)
2. Consider other methods for bladder management such as intermittent catheterization,
or external male or female collection devices, when appropriate. (L)
3. Use appropriate technique for catheter insertion. (M)
4. Consider working in pairs to help perform patient positioning and monitor for
potential contamination during placement. (L)
5. Practice hand hygiene (based on CDC or World Health Organization [WHO]
guidelines) immediately before insertion of the catheter and before and aer any
manipulation of the catheter site or apparatus. (L)
6. Insert catheters following aseptic technique and using sterile equipment. (L)
7. Use sterile gloves, drape, and sponges, a sterile antiseptic solution for cleaning the
urethral meatus, and a sterile single-use packet of lubricant jelly for insertion. (L)
8. Use a catheter with the smallest feasible diameter consistent with proper drainage to
minimize urethral trauma but consider other catheter types and sizes when warranted
for patients with anticipated difficult catheterization to reduce the likelihood that a
patient will experience multiple, sometimes traumatic, catheterization attempts. (L)
Management of indwelling catheters
1. Properly secure indwelling catheters aer insertion to prevent movement and urethral
traction. (L)
2. Maintain a sterile, continuously closed drainage system. (L)
3. Replace the catheter and the collecting system using aseptic technique when breaks in
aseptic technique, disconnection, or leakage occur. (L)
4. For examination of fresh urine, collect a small sample by aspirating urine from the
needleless sampling port with a sterile syringe/cannula adaptor after cleansing the port
with disinfectant. (L)
5. Facilitate timely transport of urine samples to laboratory. If timely transport is not
feasible, consider refrigerating urine samples or using sample collection cups with
preservatives. Obtain larger volumes of urine for special analyses (eg, 24-hour urine)
aseptically from the drainage bag. (L)
(cont'd)