CAUTI Facts
True or False: CAUTIs contribute to increased hospital length of stay, morbidity, and mortality for our patients
True
What is the difference between colonization and infection? Why does the difference matter?
Colonization is the presence of microorganisms without causing an infection (expected finding in chronic Foley patients)
Infection is when the microorganisms invade tissues and trigger a response (fever, elevated WBCs, pain, etc.)
Inappropriate cultures can detect a peaceful colonization as an infection, leading to unnecessary antibiotic orders, increasing risk of MDROs
What RASS score does the patient need to qualify as "Therapeutic Sedation"?
RASS -4 or -5
Which of the following should be used on the Foley catheter itself for proper CAUTI prevention- Purple hygiene wipes, CHG wipes, Super-Sani cloth wipes
CHG wipes. Purple hygiene wipes are used for peri care
Who has the biggest impact on CAUTI prevention?
The nurse!
True or False: A urine culture can be collected without exchanging the Foley catheter as long as it was placed <72 hours ago
True! A Foley placed GREATER THAN 72 hours ago needs to be exchanged prior to urine collection
Nephrology is following your patient for an AKI. Is this an indication to keep the Foley in?
Not necessarily, AKIs can improve. Use your clinical judgement, there are many other methods to getting accurate output. If unsure, clarify with renal!
True or false- dependent looping of the drainage tubing can cause a slowing or stagnant flow of urine, increasing the risk of a CAUTI
True
By what percent does a patient's risk for CAUTI increase for every day a Foley is left in place?
5% every day
True or False: Cloudy, malodorous urine is an indication for a urine culture
FALSE! Cloudy and/or bad smelling urine without accompanying symptoms is NOT a sign of infection.
I am unsure if the Foley can be removed, what should I do?
Ask your charge nurse or provider for clarification
This must be done every day for each patient to help prevent CAUTIs and CLABSIs
CHG baths
True of False: CAUTIs are an unavoidable risk of foleys
False!
True or False: Urine cultures can be obtained as a "clean catch" specimen with the bedpan.
False! "Clean catch" must be collected from midstream urine after perineal cleansing. Most ICU patients without foleys will require an aseptic straight cath.
Is "spinal precautions" a Foley indication for my post-op spine patient?
No! "Spinal precautions" is for unstable spines requiring strict bedrest and log rolling
True or False- If your patient has a rectal tube and a Foley catheter, it's preferred to hang the collection bags on the same side of the bed so you can check them at the same time
False! Hang on opposite sides of bed to reduce cross-contamination
On average, what is the added healthcare costs of a single CAUTI?
$14,000
The provider orders "pan cultures". What does this mean and what should you do?
Pan cultures is an method of obtaining cultures from multiple sources to cast a wide net to discern a possible reason for fever. This is an outdated method that leads to false positives from colonizations. Escalate ASAP!
You patient doesn't meet any of the qualifications on the NDP but you aren't sure if Foley should be removed, so you chart "Concern for removal; pending clarification from provider". What do you need to do next?
Talk to provider and document under "physician notification". Two possible outcomes: communication order to keep Foley at this time and reassess tomorrow or remove foley
What should a nurse do before and after performing peri/foley care?
Hand hygiene and change gloves! Prevent cross-contamination, especially in our immunocompromised populations!!