Prevention of Catheter associated Urinary Tract Infections
- Indicators for Monitoring
To ensure the appropriate prevention of catheter associated urinary tract infection in hospitals and reduce the risk of CAUTI, specific indicators should be monitored regularly. These are some indicators which can provide measurable data to assess compliance, identify areas for improvement, and guide interventions. Here are some key indicators that can be included in hospital guidelines for prevention of CAUTI.
a) Process Measures:
1. Compliance with educational program:
Calculate percent of personnel who have proper training:
● Numerator: number of personnel who insert urinary catheters and who have proper training
● Denominator: number of personnel who insert urinary catheters
● Standardization factor: 100 (i.e., multiply by 100 so that measure is expressed as a percentage)
2. Compliance with documentation of catheter insertion and removal dates:
Conduct random audits of selected units and calculate compliance rate:
● Numerator: number of patients on unit with catheters with proper documentation of insertion and removal dates
● Denominator: number of patients on the unit with a catheter in place at some point during admission
● Standardization factor: 100 (i.e., multiply by 100 so that measure is expressed as a percentage)
3. Compliance with documentation of indication at insertion
Percentage of patients with IUC insertion records in which an indication was documented at or prior to the time of insertion
● Numerator: Patients with IUC insertion records in which an indication was documented at or prior to the time of insertion
● Denominator: number of patients on the unit with inserted catheter
● Standardization factor: 100 (i.e., multiply by 100 so that measure is expressed as a percentage)
b) Outcome Measures:
1. Rates of CAUTI (Number of CAUTI per 1000 catheter-days)
Measurement of rates allows an individual facility to gauge the longitudinal impact of implementation of prevention strategies:
● Numerator: number of CAUTIs in each location monitored
● Denominator: total number of urinary catheter-days for all patients that have an indwelling urinary catheter in each location monitored
● Standardization factor: Multiply by 1000 so that the measure is expressed as cases per 1000 catheter-days.
2. Rate of bloodstream infections secondary to CAUTI (Number of bloodstream infections secondary to CAUTI per 1000 catheter-days):
Numerator: number of episodes of bloodstream infections secondary to CAUTI
Denominator: total number of urinary catheter-days for all patients that have an indwelling urinary catheter in each location monitored
Standardization factor: Multiply by 1000 so that the measure is expressed as cases per 1000 catheter-days
3. Device Utilization Ratio (DUR): The catheter utilization ratio is the number of urinary catheter-days per number of patient-days in a given period. This is a measure of the total patient-days in which a urinary catheter was used and can be used as a marker for risk of infection.
● Numerator: Number of Catheter Days for a location
● Denominator: Number of Patient Days for a location
According to the approved CDC criteria,
*Device days are the total number of days of exposure to urinary catheter for all the patients during the selected time period.
*Patient days are the total number of days patients are in the ICU during the selected time period
1.10 Plan to Update this National Clinical Guideline
This guideline will be reviewed and updated when new evidence emerges that is likely to influence the recommendations.