Preventing Catheter-Associated Infections in Hospitals: New Recommendations
Indwelling catheters, commonly used in hospitals, can lead to infections and other complications if not managed properly. To address this issue, five medical societies have developed new recommendations aimed at preventing catheter-associated urinary tract infections in acute care hospitals. These recommendations emphasize the importance of avoiding unnecessary catheter use and promptly removing catheters that are no longer needed. The findings have been published in the journal Infection Control & Hospital Epidemiology.
Dr. Payal Patel, an infectious disease physician at Intermountain Health and lead author of the update, highlights the multidisciplinary nature of preventing infections related to indwelling urinary catheters. Various healthcare professionals, including doctors and nurses, play a crucial role in ensuring patient safety.
Urinary tract infections are among the most common healthcare-associated infections, with up to three-quarters of cases being attributed to indwelling urinary catheters. These infections have been linked to increased hospital mortality rates and longer stays, resulting in an average cost of nearly $2,000 per hospitalized patient.
The updated recommendations provide a model called Disrupting the Lifecycle of the Urinary Catheter, which offers alternatives to indwelling catheters and provides guidance on their safe insertion and maintenance. It also emphasizes the need for healthcare personnel to initiate timely catheter removal. Non-catheter strategies, such as prompt toileting, urinals, bedside commodes, incontinence garments, intermittent straight catheterization, or external urinary catheters, are suggested as alternatives.
Duration of catheterization is a significant risk factor for infection, so the authors recommend daily review of the continued need for catheters, along with automated reminders or regular rounds to assess patients with urinary catheters. Other essential practices outlined in the recommendations include ensuring the availability of supplies for both catheter and non-catheter management of urinary issues, as well as proper positioning of catheters to prevent kinking of tubing, which increases infection risk. Furthermore, healthcare professionals should receive education on urine culture stewardship and appropriate indications for ordering urine cultures.
This update represents an enhancement to the 2014 publication Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals. The Compendium, initially published in 2008, is a collaborative effort among several organizations and societies, including the Society for Healthcare Epidemiology, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission. Over 100 experts worldwide have contributed to the Compendium, making it a comprehensive and globally informed resource.
This urinary catheter paper is the final installment in the latest Compendium update, which began with strategies to prevent pneumonia associated with ventilator and non-ventilator use. The update also includes sections on implementing infection prevention strategies, hand hygiene, methicillin-resistant Staphylococcus aureus infections, Clostridioides difficile infections, surgical site infections, and central line-associated bloodstream infections.
The Compendium articles provide evidence-based strategies, performance measures, and implementation approaches. Recommendations are derived from rigorous review of scientific literature, evaluation of evidence, practical considerations, and consensus among experts in the field.
The newly developed recommendations regarding catheter-associated urinary tract infections in hospitals provide invaluable guidance to healthcare professionals. Implementing these strategies can significantly reduce the incidence of infections, improve patient outcomes, and ultimately lead to a safer healthcare environment.
