The Impact of CAUTI

ERASE CAUTI

CAUTI is one of the most common healthcare-acquired infections¹, costing at least $1,200 per episode⁵,—money no longer reimbursed by CMS.⁶

Common Obstacles to Practice Change

Given the clinical and financial impact of CAUTI, updated prevention protocols have been recommended by the CDC and numerous professional societies. But putting evidence into practice isn't easy. That's why evidence-based practices aren't necessarily implemented right away—even when they substantially reduce infection risk.²

Competing priorities.

Initiatives to prevent CAUTI often have to compete with other priorities that take time and put demands on staff.⁸

“This is how we’ve always done it.”

Caregiver and cultural biases for longstanding care routines are often resistant to change.⁹

Nursing workload.

Some nurses prefer indwelling urinary catheters (IUCs), saying it’s easier to monitor output and collect a specimen, and the patient can rest more. Others think catheters save time because they don’t have to assist patients with toileting.¹⁰

Patient or family request.

A family member may request an IUC because their loved one can’t get up or walk. Incontinent patients will sometimes talk their doctor or nurse into keeping the catheter in.¹⁰

References
- 1. Urinary Tract Infection (Catheter-Associated Urinary Tract Infection (CAUTI) and Non-Catheter-Associated Urinary Tract Infection (UTI) and Other Urinary System Infection (USI) Events. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nhsn/PDFs/pscManual/7pscCAUTIcurrent.pdf. Accessed August 21, 3015.
  
  2. Saint S, Olmsted RN, Fakih MG, et al. Translating Health Care-Associated Urinary Tract Infection Prevention Research Into Practice via the Bladder Bundle. The Joint Commission Journal on Quality and Patient Safety. 2009;35(9), September 2009:449-455. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791398/ Accessed August 24, 2015.
  
  3. How-To Guide: Prevent Catheter-Associated Urinary Tract Infection. Institute for Healthcare Improvement; 2011. Available at: http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventCatheterAssociatedUrinaryTractInfection.aspx Accessed August 21,2015.
  
  4. Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA. Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009. Infec Control Hosp Epidemiol 2010;31:319-26. Available at http://www.jstor.org/stable/10.1086/651091 Accessed August 21,2015.
  
  5. 1 R3 Report: Catheter-Associated Urinary Tract Infections, Oakbrook Terrace, IL: The Joint Commission; 2011. Available at http://www.jointcommission.org/assets/1/18/R3_Report_Issue_2_9_22_11_final.pdf Accessed August 21, 2015.
  
  6. Meddings J, Kreiin SL, Fakih MG, et al. Reducing Unnecessary Urinary Catheter Use and Other Strategies to Prevent Catheter-Associated Urinary Tract Infections: Brief Update Review. In: Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Mar. (Evidence Reports/Technology Assessments, No. 211.) Chapter 9. Available from: http://www.ncbi.nlm.nih.gov/books/NBK133354/ Accessed August 25, 2015.
  
  7. Barlow K. 44% of Hospitals To Receive Multiple P4P Penalties—Will You? The Advisory Board Company. Available at: https://www.advisory.com/research/cardiovascular-roundtable/cardiovascular-rounds/2015/03/p4p-penalties Accessed October 3, 2015.
  
  8. Association for Professionals in Infection Control and Epidemiology. On the CUSP: Stop CAUTI Supplement—Spring 2014. Available at: http://apic.org/Resource_/PublicationIssueForm/10510bd2-57f0-42f4-ace0-ccd0ddf23b65/File/On-CUSP-Stop-CAUTI-final-supplement.pdf Accessed August 21, 2015.
  
  9. Hanchett M. Preventing CAUTI: A Patient-Centered Approach. Prevention Strategist 2012;9:42-50. Available at: http://apic.org/Resource_/TinyMceFileManager/epublications/CAUTI_feature_PS_fall_12.pdf Accessed September 16, 2015.
  
  10. Krein SL, Kowalski CP, Harrod M, et al. Barriers to Reducing Urinary Catheter Use: A Qualitative Assessment of a Statewide Initiative. JAMA Internal Medicine. 2013;173(10):881-886. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665648/ Accessed September 21, 2015.
  
  11. Green M. Standard Use Catheter May Be Linked to CAUTIs: 6 Things to Know. Becker’s Hospital Review. July 29, 2015. Available at: http://www.beckershospitalreview.com/quality/standard-use-catheter-may-be-linked-to-cautis-6-things-to-know.html?tmpl=component&print=1&layout=default&page= Accessed July 31, 2015.
  
  12. Internal data. Report available upon request.
  
  13. Streamline Evidence-Based RN Tool: Catheter Associated Urinary Tract Infection (CAUTI) Prevention. American Nurses Association. Available at: http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Improving-Your-Practice/ANA-CAUTI-Prevention-Tool/ANACAUTI-Prevention-Tool.pdf Accessed August 24, 2015.
  
  14. Greene L, Marx J, Oriola S. Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs). Association For Professionals in Infection Control and Epidemiology. Available at: http://www.apic.org/Resource_/EliminationGuideForm/c0790db8-2aca-4179-a7ae-676c27592de2/File/APIC-CAUTIGuide.pdf.
  
  15. Saint S, Kowalski CP, Kaufman SR, et al. Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study. Clin Infect Dis. 2008;46(2):243-250. Available at: http://cid.oxfordjournals.org/content/46/2/243.full Accessed August 21, 2015.
  
  16. 2015 National Patient Safety Goals. The Joint Commission. Available at: http://www.jointcommission.org/assets/1/6/2015_NPSG_HAP.pdf Accessed November 4, 2015.
  
  17. Transcript of catheter-associated UTI’s presentation by Dr. Sanjay Saint. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hicpac/uti_saint_video.html Accessed August 6, 2015.
  
  18. Urinary Catheter Care: Cleaning and Personal Hygiene. Presented by ATI™ Nursing Education. Available at: http://www.atitesting.com/ati_next_gen/skillsmodules/content/urinary-catheter-care/equipment/cleaning-and-personal-hygiene.html Accessed October 2, 2015.
  
  19. Data on file. Available upon request.