UTIs: Bundling May Reduce Incidence

By Karen Siroky, RN, MSN

The Institute for Healthcare Improvement (IHI; www.ihi.org) bundle on reducing CAUTI includes four key steps. Each step is critical to the success of the bundle and nurses can impact each and every step.

First, avoid unnecessary catheters. The use of indwelling catheters should be limited and used only when indicated. Guidelines from both the Centers for Disease Control (www.cdc.gov) and IHI research shows that many catheterizations are unnecessary, so consider the actual need for the catheter before placement.

Second, use aseptic technique. This refers to all activities performed during and after the time of placement, such as  sample retrieval and catheter care. The catheter provides a direct, physical route to the bladder, therefore the risk of bacterial contamination is significant. Once again, research shows that with good technique, the risk of contamination can be eliminated.

Third, maintain the catheter based on recommended guidelines. This includes maintaining a closed, aseptic system, ensuring that urine flow is not obstructed and keeping the collection bag below the level of the bladder at all times.

Fourth, and perhaps the most important, is the daily assessment of the need for a catheter. Studies show that there is a strong relationship between the number of days a catheter is inserted and the risk of UTI. Daily assessment and the removal of catheters as soon as possible, are both critical to the reduction in CAUTI.

Always follow your organizational guidelines for CAUTI.


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