Implementation of a Nurse-Driven Protocol to Prevent Catheter-Associated Urinary Tract Infections

Abstract

This article describes a quality improvement project to decrease catheter-associated urinary tract infections (CAUTIs) at an academic medical center. A criteria-based, nurse-driven protocol for discontinuation of indwelling catheters and use of bladder ultrasonography in conjunction with intermittent catheterizations was the foundation for change. The CAUTI rate, the number of CAUTIs, cost of medications and supplies associated with treating CAUTIs, catheter duration, and intensive care unit length of stay decreased after protocol implementation.

The effect of education of nurses on preventing catheter‐associated urinary tract infections in patients who undergo hip fracture surgery

“…At the end of the study, the researchers observed that catheter durations decreased significantly. In a study by Alexaitis and Broome (), utilising nurse‐guided catheter protocols decreased catheter duration by 2.5 days. The decreased catheter duration in our study is consistent with the literature.…”

Review of Strategies to Reduce Central Line‐Associated Bloodstream Infection (CLABSI) and Catheter‐Associated Urinary Tract Infection (CAUTI) in Adult ICUs

“…Of the 28 CAUTI studies that met the inclusion criteria (reporting outcomes for 30 intervention cohorts), 14 studies (reporting outcomes for 16 intervention cohorts) were performed in the US. 28,34,53,66,68,[133][134][135][136][137][138][139][140][141] Study designs included 2 RCTs (focused on urinary catheter avoidance or removal 142 and chlorhexidine bathing 68 ) and 26 nonrandomized, before-after studies 28,30,33,34,53,66,109,[114][115][116][133][134][135][136][137][138][139][140][141][143][144][145][146][147][148][149] (Appendix Table 1). The number of hospitals per study varied from 1 to 53, with the majority being single-hospital interventions.…”

“…Interventions to avoid indwelling urinary catheters included education about external catheters, 28,34,109,133,140,[144][145][146] urinary retention protocols, 34,144,135,141 and bladder scanner simulation training. 133 Interventions to improve aseptic insertion 28,34,66,109,116,139-141-143-146,150 and maintenance care 28,34,66,109,116,133,135,136,[139][140][141][143][144][145][146]150 of urinary catheters were common. Four studies used a standardized urinary catheter kit or cart, 28,34,139,142 and 2 studies used a commercial urinary catheter securement device.…”

Impacto de la ecografía volumétrica portátil en el sondaje vesical por retención urinaria en una unidad de medicina interna

“…Se usa en el 26% de las Unidades de Cuidados Críticos en EEUU (12) . Es un método que es útil en el diagnóstico de retención urinaria tras una cirugía (13) , además, su uso reduce las incidencias de ITU (14) y según la revisión de D'Silva sugiere que debería usarse en pacientes con sospecha de grandes volúmenes residuales post-micción (15) . La utilización de la ecografía volumétrica vesical portátil ha conseguido, por otro lado, aumentar los casos de éxito en sondajes vesicales en pacientes pediátricos en urgencias (16) .…”