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
> 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).
patient, and avoid allowing the draining spigot to touch the collecting container (A-II).
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 NOT be considered a routine part of CAUTI prevention
ÎDo NOT screen for asymptomatic bacteriuria in catheterized patients (A-II).
ÎDo NOT treat asymptomatic bacteriuria in catheterized patients except before invasive urologic procedures (A-I).
Î AVOID catheter irrigation (A-I). ÎDo NOT use systemic antimicrobials routinely as prophylaxis (A-II). ÎDo NOT change catheters routinely (A-III).
