Importance: A urinary tract infection occurs when microorganisms enter the urinary tract and cause infection. The infection is considered catheter-associated if an indwelling catheter has been in place for greater than two days on the infection date (CDC, 2015). Twelve to sixteen percent of adult inpatients will have a urinary catheter at some time during their hospital stay (Weinstein et al., 1999). CAUTI complications can cause discomfort in the patient and increase hospital length of stay, health care costs and mortality (Saint, 2000). The direct costs associated with CAUTI range from $749 to $1,007 per patient (Scott, 2009). Moreover, the Centers for Medicare and Medicaid Services stopped reimbursing for any costs associated with CAUTIs in 2008. Listen to Jerri’s story to learn more about the impact of CAUTI from the patient’s perspective.
The most significant CAUTI risk factor is the duration of catheterization (Lo et al., 2013). Hospitals can prevent the risk of infection by ensuring catheters are appropriately indicated; many unnecessary catheters are placed in the emergency department (Gardam et al., 1998; Faikh et al., 2010; Faikh et al., 2012). Catheter restrictions, stop orders, catheter reminders, condom catheters and nurse-initiated catheter removal protocols are some of the strategies hospitals can use to limit catheter use and duration (Meddings et al., 2013). However, hospital culture can be one of the greatest barriers to implementing and sustaining evidence-based practices, so interventions should be designed and evaluated with these dynamics in mind.
Accomplishments: From 2011 to 2014, the AHA/HRET HEN prevented an estimated 2,805 CAUTIs with an estimated cost savings of over $2.8 million.
PfP Goal: By September 23, 2018, each participating HIIN hospital reduces CAUTIs by at least 40 percent or maintains a rate of zero for 12 months.
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