Urinary tract infections account for approximately 40% of these infections with 80% of these attributable to indwelling urethral catheters.1
There is evidence that multi-component interventions can reduce the development of catheter associated infections and thus harm. This section focuses on the evidence for these interventions and how they can be applied.
Catheter care bundles can reduce the risk of developing catheter associated infections and therefore improve both patient safety and mortality. The evidence base for these interventions is examined, and four interventions which should be uniformly applied are outlined, in the How-to Guide: Prevent Catheter-Associated Urinary Tract Infections from the Institute of Healthcare Improvement. The guide also includes step-by-step guidance on introducing and implementing these interventions using the Model for Improvement.
Evidence based guidelines
An evidence-based set of guidelines to prevent catheter associated infection are outlined in the paper Evidence-based approach to preventing catheter-associated urinary tract infections in older people by Pratt and Pellowe. They particularly focus on older people above 80 years of age and helpfully highlight interventions which have previously been shown to have no evidence of efficacy.
Recommendations for each aspect of catheter related care from indications for insertion to education for staff and patients are synthesised in Guidelines for the prevention of catheter associated urinary tract infection from the Health Protection Surveillance Centre in Ireland. The guidelines include an evidence review, a sample care bundle, a patient education leaflet and various other tools to support implementation of the guidelines.
Institute of Healthcare Improvement. How-to Guide: Prevent Catheter-Associated Urinary Tract Infections. Cambridge, Massachusetts, 2011. Accessed 15th April 2013