Written Description

Urinary Tract Infections (UTI) are one of the most common infections in humans.
It is reported there are 150 million cases worldwide. UTI’s account for
approximately 36% of healthcare associated infections and of this 36% 80% of them
are Catheter Associated Urinary Tract Infections (CAUTI). CAUTI are the cause of
nearly 20% of acute care hospital bacteremia infections and 50% in long-term care
facilities as a cause of bacteremia. There are approximately 13,000 deaths in the
U.S. annually that are related to CAUTI. CAUTI is costing the U.S. around 340 million
annually.

Some of the biggest issues surrounding CAUTI are the complications associated with
them. These include, bacteremia, meningitis, septic arthritis, osteomyelitis, and
endocarditis; which usually require admission to expensive Intensive Care Units
across the country and easily can cause death. Common bacteria involved with
CAUTI are E. coli and K. pneumonia. Colonization of bacteria to the catheter bag
itself have been often involved as a source for cases of bacteremia in health care
settings. There are also problems with resistance of these bacteria.

CAUTI, first of all, is a problem for us as a nation as it is very expensive. With all the
talk of cheaper health care CAUTI certainly is not helping that situation.
Additionally, CAUTI can be difficult to prevent. Not every patient can avoid the use
of a catheter. Some of them absolutely need them. The other difficulty with CAUTI
is resistance of bacteria and at times systemic use of antibiotics are not successful or
slowly resolved requiring more admission days to health care facilities and driving
up costs. Efforts to educate about prevention in care facilities may also not be
entirely efficient as this requires timely removal or replacement of catheters and
appropriate management which isn’t always possible in understaffed or busy health
care centers.
One solution I would focus on in our poster we are developing would be to avoiding
use of the catheter in the first place. Education to nurses and providers should
include indications of the use of catheterization that is appropriate and not just for
patients where urinating on their own is inconvenient for example. Providers
especially should be reminded as to indications of catheter use as they are “ground-
zero” for these CAUTI events. Catheters should be ordered by providers with
caution and strict care to the recommendations for use. It is not a perfect system
but education on indications, correct management, and active CAUTI surveillance
with well developed protocols has resulted in decreased CAUTI rates from 18.5% to
9.2% which was a significant finding in one study. Furthermore, not just anyone can
place a catheter. This is a sterile procedure and requires meticulous technique in
order to be inserted in a sterile fashion. Training and certification for those that
would place a catheter would help ensure if indeed a catheter is indicated that it is
placed properly. As such our education materials will highlight these measures for
appropriate catheter care and will be posted in nurses stations or similar area so
staff can constantly review this information for better care.