Avoiding the unnecessary use of indwelling catheters and promptly removing catheters when no longer needed are the first steps in preventing catheter-associated urinary tract infections (UTIs) in healthcare settings, according to new recommendations published today in the journal Infection Control & Hospital Epidemiology. These settings include long-term care communities.
Hospitals can prevent catheter-related UTIs if they avoid the unnecessary use of indwelling catheters and, in a timely fashion, remove catheters that are no longer needed, according to the report. The report includes new recommendations from five medical societies. It was published on Aug. 25 in the journal Infection Control & Hospital Epidemiology.
Up to three-quarters of UTIs arise from an indwelling urinary catheter. UTIs are one of the most common infections acquired in healthcare settings. They’re linked to higher hospital mortality and longer hospital stays, not to mention higher costs.
“Urinary catheters can be associated with infection and also with non-infectious harms like trauma and obstruction,” said Payal Patel, MD, an infectious disease doctor at Intermountain Health and lead author. “Prevention of infection related to use of typical indwelling urinary catheters is multidisciplinary. Many members of the healthcare team, including doctors and nurses, have a role.”
The new document updates guidance that came out in 2014, and was first published in 2008.
The recommendations give alternatives to indwelling catheters, share guidance for safely inserting and maintaining catheters, and give healthcare workers reminders to remove them on time. Non-catheter strategies include prompt toileting, urinals, bedside commodes, incontinence garments, and/or using intermittent straight catheterization or external urinary catheters.
Healthcare workers should have a daily review of the catheter — even just a reminder that the person has a catheter in. Supplies should be available for people not on catheters or with catheters. Catheters should be properly positioned to avoid a bend or kink in the tube, which can boost the risk for infection, the report said.
The group advises that healthcare settings educate workers about urine culture stewardship and give indications for urine cultures.
The report is sponsored by the Society for Healthcare Epidemiology (SHEA), which worked with these organizations to devise the recommendations: Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association and The Joint Commission.
