Pragmatic review of interventions to prevent catheter-associated urinary tract infections (CAUTI) in adult inpatients

Link to article at PubMed

J Hosp Infect. 2023 Apr 2:S0195-6701(23)00109-3. doi: 10.1016/j.jhin.2023.03.020. Online ahead of print.


BACKGROUND: Urinary tract infections (UTIs) are one the most common hospital-acquired complications. Insertion of a urinary catheter and the duration of catheterisation are the main risk factors, with catheter-associated UTIs (CAUTIs) accounting for 70-80% of hospital-acquired UTIs. Guidance is available regarding the prevention of hospital-acquired CAUTI, however, how best to operationalise this guidance remains a challenge.

AIM: This pragmatic review aimed to map and summarize the peer-reviewed literature on model of care interventions for the prevention of CAUTI in adult inpatients.

METHODS: PubMed, CINAHL and SCOPUS were searched using key terms for CAUTI and inpatient and evaluation. Articles had to report UTI, CAUTI or urinary catheter outcomes. Articles were systematically screened, data systematically extracted, and interventions classified by intervention type.

FINDINGS: The review included 70 articles. Interventions were classified as single component (n=19) or multi-component (n=51). Single component interventions included: daily rounds or activities (n=4), protocols and procedure changes (n=6), reminders and order sets (n=5), audit and feedback interventions (n=3) and education with simulation (n=1). Overall, daily catheter reviews and protocol and procedure changes demonstrated the most consistent effects on catheter and CAUTI outcomes. The components of multi-component interventions were categorised to map common elements and identify novel ideas.

CONCLUSION: A range of potential intervention options with evidence of a positive effect on catheter and CAUTI outcomes were identified. It is intended to provide a 'menu' of intervention options for local decision makers, enabling them to identify interventions that are relevant and feasible in their local setting.

PMID:37015257 | DOI:10.1016/j.jhin.2023.03.020

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