ÎÎEnsure that all ICU beds used for patients undergoing ventilation have a
built-in tool to provide continuous monitoring of the angle of incline (B-III).
Approaches that should NOT be considered a routine part of
VAP prevention
ÎÎDo NOT routinely administer intravenous immunoglobulin, white-cellstimulating factors (filgrastim or sargramostim), enteral glutamine, or
chest physiotherapy (A-III).
ÎÎDo NOT routinely use rotational therapy with kinetic or continuous lateral
rotational therapy beds (B-II).
ÎÎDo NOT routinely administer prophylactic aerosolized or systemic
antimicrobials (B-III).
Prevention of Catheter-Associated Urinary Tract Infection (CAUTI)
Basic practices for prevention and monitoring of CAUTI*
ÎÎAppropriate infrastructure for preventing CAUTI
>> Provide and implement written guidelines for catheter use, insertion, and maintenance
(A-II).
>> Ensure that only trained, dedicated personnel insert urinary catheters (B-III).
>> Ensure that supplies necessary for aseptic-technique catheter insertion are available
(A-III).
>> Implement a system for documenting the following information in the patient record:
indications for catheter insertion, date and time of catheter insertion, individual who
inserted catheter, and date and time of catheter removal (A-III).
>> Ensure that there are sufficient trained personnel and technology resources to support
surveillance of catheter use and outcomes (A-III).
ÎÎEducation and training
>> Educate healthcare personnel 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 (A-III).
ÎÎAppropriate technique for catheter insertion
>> Insert urinary catheters only when necessary for patient care and leave them in place
only as long as indications persist (A-II).
>> Consider other methods for management, including condom catheters or in-and-out
catheterization, when appropriate (A-I).
>> Practice hand hygiene (based on Centers for Disease Control and Prevention or World
Health Organization guidelines) immediately before insertion of the catheter and
before and after any manipulation of the catheter site or apparatus (A-III).
>> Insert catheters using aseptic technique and sterile equipment (A-III).
>> Use gloves, drapes, and sponges; a sterile or antiseptic solution for cleaning the urethral
meatus; and a single-use packet of sterile lubricant jelly for insertion (A-III).
>> Use as small a catheter as possible that is consistent with proper drainage, to minimize
urethral trauma (B-III).
