Î Maintain a sterile, continuously closed drainage system (III).
Î Replace the catheter and the collecting system using aseptic technique
when breaks in aseptic technique, disconnection, or leakage occur (III).
Î 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 (III).
Î Obtain larger volumes of urine for special analyses aseptically from the
drainage bag (III).
Î Maintain unobstructed urine flow.
• Keep the collecting bag below the level of the bladder at all times. Do not place the
bag on the floor (III).
• Keep catheter and collecting tube free from kinking (III).
• Empty the collecting bag regularly using a separate collecting container for each
patient. Avoid touching the draining spigot to the collecting container (III).
Î Employ routine hygiene. Cleaning the meatal area with antiseptic
solutions is unnecessary (III).
Special Approaches for Preventing CAUTI
Perform a CAUTI risk assessment. These special approaches are recommended for use in
locations and/or populations within the hospital with unacceptably high CAUTI rates or
SIRs despite implementation of the basic CAUTI prevention strategies listed previously.
Î Implement an organization-wide program to identify and remove
catheters that are no longer necessary using one or more methods
documented to be effective (II).
Î Develop a protocol for management of postoperative urinary retention,
including nurse-directed use of intermittent catheterization and use of
bladder scanners (II).
Î Establish a system for analyzing and reporting data on catheter use and
adverse events from catheter use (III).
Approaches that Should NOT be Considered a Routine Part of
CAUTI Prevention
ÎDo NOT routinely use antimicrobial/antiseptic-impregnated catheters (I).
ÎDo NOT screen for asymptomatic bacteriuria in catheterized patients (II).
Î Do NOT treat asymptomatic bacteriuria in catheterized patients except
before invasive urologic procedures (I).
Î Avoid catheter irrigation (II).
Î Do NOT use systemic antimicrobials routinely as prophylaxis (III).
Î Do NOT change catheters routinely (III).
12
Catheter-Associated Urinary Tract Infections
