Release of human growth hormone during sleep is significantly related to slow, synchronized stages of sleep and therefore would seem to be controlled by related neural mechanisms. When sleep-waking cycles are reversed by 12 hours, the release of growth hormone with sleep is reversed; thus release does not follow an inherent circadian rhythm independent of sleep.

Evidence from parts 1 and 2 of this Evidence-Based Report Card provides a sound basis for designing an evidence-based program to prevent CAUTI. Essential elements of a CAUTI prevention program include staff education, ongoing monitoring of CAUTI incidence, monitoring catheter insertion and ensuring prompt removal, and careful attention to techniques for catheterization and catheter care.