Catheter-Associated Urinary Tract Infection

Quality indicators, in the realm of nursing are directly related to the care we provide at the bedside, and offer us a means of evaluating how the nursing processes that are currently in place can improve care and influence the outcomes of our patients (Montalvado, 2007). Monitoring catheter-associated urinary tract infection (CAUTI) is a National Database of Nursing Quality Indicator, endorsed by the National Quality Forum (NQF) that directly impacts nursing practice in the Emergency Room setting (Montalvado, 2007).

Infections of the urinary tract account for 40% of all hospital-acquired infections- with 80% of that total being related to catheters (Quinn, 2015). Because of the high incidence of CAUTI, reduction in the number of these infections has been an ongoing goal for healthcare organizations. Collaboration amongst nursing, medicine, and infection control in conjunction with the delivery of quality care is necessary in the fight to reduce the occurrence of these preventable infections.

Knowledge alone is insufficient when understanding the context or pattern of a patient’s condition. Anticipating, comprehending and being aware of the 3ps in the clinical setting helps to interpret the circumstances of a situation, and fosters the delivery of quality care (Laureate Education, 2013). Understanding the indications for foley-catheter placement enables the nurse to critically think about the necessity of the catheter. Is there a valid reason for the catheter? Are they in CHF, have been given Lasix, and are in need of intake and output monitoring? Is the patient hemodynamically unstable and is on pressors (such as Norepinephrine or Dopamine) to maintain their mean arterial pressure? Have they had a surgery near the site (such as debridement of pressure ulcers)? Neurogenic bladder? Having knowledge about the physiology of the patient, the pathophysiology of the medicines administered, and the necessary physical assessment skills to care for a patient, nurses can be empowered to collaborate with physicians to eliminate the unnecessary usage of foley catheters when they are not indicated, and work together to prevent CAUTIs in the healthcare organization.