Remind patients and families of important maintenance procedures, including hand hygiene, and maintaining an unobstructed flow and positioning of the drainage bag below the level of the bladder. Tell them to report symptoms of bladder fullness, pain or leakage immediately. Teach them about the importance of adequate fluid intake (a minimum of 1500ml/day) and to avoid bladder irritants (such as caffeine, carbonated beverages and citrus). Review the catheter care maintenance strategies we discussed with the patient and their family. Teach the patient to ask every day, “when can this catheter come out.”

These are the components to get you started in either creating or refining a CAUTI program.

At a minimum, documentation should include the reason for catheter insertion, the date and time inserted, who inserted it, the type and size of the catheter, and the date and the time catheter was removed. In addition, the indication for the catheter should be documented each day.

Staff education of those making decisions, inserting and/or removing catheters, and providing care and maintenance is a key feature of implementing best practices. Alternatives to catheters should be available. Multidisciplinary teams, as with other procedures and conditions, will help to ensure the best possible care. A protocol for monitoring and decision-making is an important place to start.

Catheter associated urinary tract infections have significant adverse clinical and financial outcomes—both to our patients and our organizations. The only way to fully assure that he risk for CAUTIs has been minimized is to not use indwelling catheters in the first place, or to discontinue ones that are currently in place. Use of the A, B, C's of the “bladder bundle” of evidence-based interventions as seen here, and developed by Dr. Sanjay Saint of the University of Michigan, is a helpful way to remember CAUTI best practices.

Any individual intervention will improve care but utilizing a variety of interventions together can result in superior improvement. Utilizing evidence-based guidelines for the prevention and management of CAUTIs has been estimated to realize the potential for 380,000 fewer infections and 9,000 fewer deaths annually.[5]