WK6AssgnHerreraS.(extension).doc - 1 Catheter-Associated...

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Catheter-Associated Urinary Tract Infections (CAUTI)
Sandra L. Herrera
Walden University
Leadership Competencies in Nursing and Healthcare
NURS-4220-5
February 17, 2018

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Catheter-Associated Urinary Tract Infections (CAUTI)
According to The Centers for Disease Control and Prevention (CDC, 2017),
approximately 75% of hospital-acquired urinary tract infections are associated with a urinary
catheter with a prolonged use being the most critical risk factor for developing a catheter-
associated urinary tract infection (CAUTI). CAUTIs can cause an overabundance of
complications included but not limited to gram-negative bacteremia, sepsis, and mortality
(Skanlon, 2017). The purpose of this paper is to reduce CAUTI rate from 2.48 to below the target
rate of 1.71 at a Long Term Acute Care (LTAC).
Literature review
For years, healthcare has been struggling to reduce CAUTI rates, and an abundant
volume of articles and studies related to this patient safety issue are available. Most of the
articles reviewed to discuss the usage of alternative external devices to an indwelling catheter,
utilization of maintenance bundles, and daily nursing assessment of the necessity of the catheter.
The use of external continent devices (ECD) in men such as condom catheters is an alternative to
the insertion of indwelling catheters for indications such as cognitive dysfunction due to acute or
chronic illness and men with neurogenic bladder dysfunction (Gray, Skinner, & Kaler, 2016).
Qualitative studies showing results on the practice of catheter maintenance bundles in the
prevention of CAUTIs were conducted through interviews or nursing surveys. CAUTI bundles
include interventions such as appropriate catheter use, utilization of aseptic technique during
catheter insertion, a closed drainage system, and removal of the catheter as soon as possible.
(Meddings, Rogers, Krein, Fakih, Olmsted, & Saint, 2014). In most cases, a Registered Nurse of
a Licensed Vocational Nurse insert the catheter; consequently, policy and procedures, unit

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guidelines, skill checks, nursing competencies, random audits, and continuing education should
be promoted (McNeill, 2017).
Removal of the catheter as soon as possible and daily nursing assessments is vital in the
bundle to prevent CAUTIs. The longer a catheter is in place, the higher risk for a patient to
acquire an infection. Qualitative research has shown the risk of developing bacteriuria on
catheterized patients as high as 3% to 10% per day and close to 100% after the catheter has been
in place for 30 days (McNeill, 2017).
Daily assessment for the continuance of a catheter should be nurse-driven and supported
by charge nurses, physicians, and infection control interventionists. In the United States, the
statistics are alarming, approximately five million catheters are placed annually, and 50% of the