Guide to Preventing Catheter-Associated - apic.org

1 Guide to Preventing Catheter-Associated Urinary Tract Infections About APIC. APIC's mission is to create a safer world through prevention of infection. The association's more than 14,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. About the Sponsor The distribution of this APIC Implementation Guide as a full-access online resource is made possible by the Agency for Healthcare Research & Quality (AHRQ) through the national On the CUSP: Stop CAUTI project.

2 This project represents ARHQ's commitment to improving patient safety and Preventing infections. For more information about the On the CUSP: Stop CAUTI national project, visit About the Implementation Guide Series APIC Implementation Guides help infection preventionists apply current scientific knowledge and best practices to achieve targeted outcomes and enhance patient safety. This series reflects APIC's commitment to implementation science and focus on the utilization of infection prevention research. Topic-specific information is presented in an easy-to- understand-and-use format that includes numerous examples and tools.

3 Visit to learn more and to access all of the titles in the Implementation Guide series. Printed in the United States of America First edition, April 2014. ISBN: 1-933013-57-5. All inquiries about this Guide or other APIC products and services may be directed addressed to: APIC. 1275 K Street NW, Suite 1000. Washington, DC 20005. Phone: 202-789-1890. Fax: 202-789-1899. Email: Web: Disclaimer 2014, Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) All rights reserved. Use of this APIC Guide does not grant any right of ownership or license to any user. The Association for Professionals in Infection Control and Epidemiology, its affiliates, directors, officers, and/or agents (collectively, APIC ) provides this Guide solely for the purpose of providing information to APIC members and the general public.

4 The material presented in this Guide has been prepared in good faith with the goal of providing accurate and authoritative information regarding the subject matter covered. However, APIC makes no representation or warranty of any kind regarding any information, apparatus, product, or process discussed in this Guide and any linked or referenced materials contained therein, and APIC assumes no liability therefore. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE INFORMATION AND MATERIALS PROVIDED. IN THIS Guide ARE PROVIDED ON AN AS-IS BASIS AND MAY INCLUDE ERRORS, OMISSIONS, OR OTHER. INACCURACIES. THE USER ASSUMES THE SOLE RISK OF MAKING USE AND/OR RELYING ON THE INFORMATION.

5 AND MATERIALS PROVIDED IN THIS Guide . APIC MAKES NO REPRESENTATIONS OR WARRANTIES ABOUT. THE SUITABILITY, COMPLETENESS, TIMELINESS, RELIABILITY, LEGALITY, UTILITY OR ACCURACY OF THE. INFORMATION AND MATERIALS PROVIDED IN THIS Guide OR ANY PRODUCTS, SERVICES, AND TECHNIQUES. DESCRIBED IN THIS Guide . ALL SUCH INFORMATION AND MATERIALS ARE PROVIDED WITHOUT WARRANTY. OF ANY KIND, INCLUDING, WITHOUT LIMITATION, ALL IMPLIED WARRANTIES AND CONDITIONS OF. MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, AND NON-INFRINGEMENT. IN NO EVENT SHALL APIC BE LIABLE FOR ANY INDIRECT, PUNITIVE, INCIDENTAL, SPECIAL, OR CONSEQUENTIAL.

6 DAMAGES ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE USE OF THIS Guide OR FOR THE USE OF. ANY PRODUCTS, SERVICES, OR TECHNIQUES DESCRIBED IN THIS Guide , WHETHER BASED IN CONTRACT, TORT, STRICT LIABILITY, OR OTHERWISE. Guide to Preventing Catheter-Associated Urinary Tract Infections Table of Contents Acknowledgments .. 5. Section 1: Epidemiology and Pathogenesis of Catheter-Associated Urinary Tract Infections.. 7. Section 2: National CAUTI Prevention Initiatives.. 12. Section 3: CAUTI Risk Assessment .. 25. Section 4: Definitions, Surveillance, and Reporting.. 29. Foley catheter Prevalence Sheet.. 39. Section 5: Patient Safety, CUSP, and Other Behavioral Models.

7 43. Section 6: Prevention.. 53. Section 7: Preventing Catheter-Associated Urinary Tract Infections in Children .. 69. Section 8: Special Populations .. 76. Appendix: Recommendations for Spinal Cord Injured Patients .. 83. 4 Association for Professionals in Infection Control and Epidemiology Guide to Preventing Catheter-Associated Urinary Tract Infections Acknowledgments The Association for Professionals in Infection Control and Epidemiology acknowledges the valuable contributions from each of the following individuals: Editor Contributors Linda Greene, RN, MPS, CIC Donna Anderson, RN, CIC. Manager, Infection Prevention Infection Preventionist Highland Hospital Beebe Healthcare Rochester, NY Lewes, DE.

8 Jennifer Boe, RN, BSN, CIC. Lead Author Infection Prevention Coordinator Kristi Felix, BA, RN, CRRN, CIC Children's Hospital of Minnesota Infection Prevention Coordinator St. Paul, MN. Madonna Rehabilitation Hospital Lincoln, Nebraska Geri A. Brown, RN, CIC. Infection Control/Employee Health Starr Regional Medical Ctr. Athens, TN. Authors Mary Jo Bellush, RN, MSN, CIC Brooke Buras, RN, BSN. Infection Preventionist Infection Prevention Nurse Excela Health Westmoreland Hospital North Oaks Health System Greensburg, PA Hammond, LA. Barbara Bor, RN, BSN, CIC Harriette Carr, RN, MSN. Infection Preventionist Infection Preventionist Gillette Children's Specialty Healthcare Carmichael, CA.

9 St. Paul, MN. Michael Cloughessy, MS, BSEH, REHS, CIC. Senior Infection Control Practitioner Cincinnati Children's Hospital Cincinnati, OH. Paula S. Forte, PhD, RN, CWCN, NEA-BC. Clinical Practice Specialist Gillette Children's Specialty Healthcare St. Paul, MN. Association for Professionals in Infection Control and Epidemiology 5. Guide to Preventing Catheter-Associated Urinary Tract Infections Maxine Garcia, RN Reviewers Infection Preventionist; Employee Health Nurse Evelyn Cook, RN, CIC. Baylor Surgical Hospital at Las Colinas Infection Preventionist Irving, TX Duke Infection Control Outreach Network Duke University Medical Center Susan A Grossberger, BSN Durham, NC.

10 Infection Preventionist UPMC Mercy Russell Olmsted, MPH, CIC. Pittsburgh, PA Director, Infection Prevention St Joseph Mercy Health System Theresa Houston, RN, BSN, CCRN Ann Arbor, MI. Critical Care Nurse Educator Beebe Medical Center Lewes, DE. Production Staff Sharon Nersinger RN Marilyn Hanchett, RN, MA, CPHQ, CIC. Infection Control Coordinator Senior Director, Professional Practice Highland Hospital Association for Professionals in Infection Control Rochester, NY and Epidemiology Washington, DC. Connie Steed, MSN, RN, CIC. Greenville Hospital System Jim Angelo University Medical Center Director, Publishing Greenville, SC Association for Professionals in Infection Control and Epidemiology Jennifer Tuttle, RN, MSNEd Washington, DC.