Abstract
Introduction:
The cornerstone of catheter-associated urinary tract infection (CAUTI) prevention is avoiding unnecessary indwelling urinary catheter (IUC) insertion [1]. As part of a long-term project to reduce the number of catheters, the most common inserted device used across MOE wards in our hospital, we recently undertook a project to improve planning (does it need to stay, can we remove it?) and the reliability of information reconciliation around their use.
Methods:
We designed a data collection tool, analysing key aspects of IUC care, measured our performance at least twice-yearly using data to educate and inform teams. After noting a drop off in documentation around planning, we designed an intervention for our electronic patient record: amending our multi-disciplinary team (MDT) prompt, encouraging teams each week to make a decision re the necessity for ongoing catheterisation. A further two cycles of audit were performed following the intervention.
Results:
Across the MOE footprint (up to 142 beds), the prevalence of IUC use averages around 25%. This has not changed significantly across the audit period. However, since the most recent intervention, there have been marked and sustained improvements in documentation and planning.
Completion of risk assessment increased from 63 to 92%, notes of change date from 81 to 92%, MDT record of use of catheter from 56 to 83% and future plan from 6-58%.
Conclusion:
We have increased the MDT awareness of our use of IUCs and by doing so seen sustained improvements in both planning and information reconciliation, thereby increasing safety. From this strengthened platform, we intend to link to ongoing work around CAUTI reduction.
In a system where change of staff is a constant, creating a lasting message is difficult and it can leave improvers feeling like they are permanently on repeat. Encouraging measurement with local improvement ideas can lead to wins that lead to permanent change.
References:
- Rosenthal VD et al. Preventing catheter-associated urinary tract infections: A position paper of the International Society for Infectious Diseases, 2024 update. IDID 2025; 151: 107304.
Comments
Catheters seen as an easy solution
This is a very common issue across trusts in the country. It is often found to be an immediate solution for a patient has not passed urine, without thinking of reasons behidn this and what can be done about it. There are many reversible causes that still avoid urinary retention. This can be important to think about when raising MDT awareness.