Increasing adherence to CAUTI guidelines: Recommendations from existing evidence (June 2022)

Summary

The European Network for Safer Healthcare (ENSH) joined forces with the European Association of Urology Nurses (EAUN) to work on a policy campaign to prevent catheter-associated urinary tract infections (CAUTI) in Europe as a path to improving patient safety and preventing anti-microbial resistance (AMR) through:

• Improvement of adherence to existing European guidelines to prevent CAUTI.
• Development of European indicators to support the European Centre for Disease Prevention and Control (ECDC) and/or national surveillance systems.

Content

Key recommendations

This list summarises key recommendations for healthcare professionals. Adherence to these recommendations would improve patient outcomes, reduce the spread of AMR and save public healthcare budgets millions of euros per year.

Proper use of the urinary catheter:

• Urethral catheters should be used only when indicated, with a closed-circuit system and a port for taking samples.
• Catheters should be removed when they are unnecessary and their indication should be assessed daily.

Proper insertion of the urinary catheter:

• Hand hygiene should be performed immediately before and after catheter insertion or any manipulation of the urethral catheter.
• A sterile/aseptic insertion technique should be used.

Proper maintenance of the urinary catheter:

• Always keep the collecting system closed (urethral catheter, drainage tube and collecting bag).
• Keep the urine flow free, without obstacles in the circuit, and the collection bag below the level of the bladder.
• Maintain good catheter hygiene and use a catheter securement device.
• Use checklists/ care bundle to aid in urinary catheter maintenance.

Guarantee the quality of the care:

• Health professionals must receive specific training on the insertion and maintenance of the urethral catheter.
• The urethral catheter insertion and maintenance protocols must be reviewed and updated periodically (every 3 years and/or when new evidence is published)
• Healthcare professionals need to receive regular feedback. Unit coordinators will periodically inform staff about urinary infections rates.

Do not:

• Do not use antiseptics and antibiotics in daily hygiene.
• Do not use prophylactic antimicrobials in the insertion, maintenance or withdrawal of the urethral catheter.
• Do not change the urethral catheter routinely and periodically.
• Do not carry out bladder washes.
• Do not take cultures if infection is not suspected, except for colonisation studies.
• Do not routinely use antimicrobial-impregnated probes.
• Do not use antimicrobial treatment in asymptomatic bacteriuria.

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