CAUTI (Catheter-Associated Urinary Tract Infection)
A healthcare-acquired UTI in patients with indwelling urinary catheters
Definition
A Catheter-Associated Urinary Tract Infection (CAUTI) is a urinary tract infection that occurs in a patient with an indwelling urinary catheter, or within 48 hours of catheter removal. It is one of the most common healthcare-acquired infections (HAIs).
Risk Factors
- Duration of catheterization (longer = higher risk)
- Female sex
- Advanced age
- Diabetes
- Improper insertion or care technique
- Breaks in closed drainage system
Signs and Symptoms
- Fever, chills
- Suprapubic or flank pain
- New onset confusion (especially in elderly)
- Cloudy, foul-smelling urine
- Hematuria
- Leukocytosis
Prevention Bundle
- Avoid unnecessary catheterization: Only insert when medically indicated.
- Aseptic insertion: Sterile technique, proper training.
- Maintain closed drainage system: Never disconnect unless necessary.
- Keep bag below bladder level: Prevents reflux.
- Daily meatal care: Soap and water; avoid antiseptics.
- Remove as soon as possible: Daily reassessment of need.
Nursing Considerations
Advocate for catheter removal. Use external catheters (condom, PureWick) when possible. Document clinical justification for continued use.
NCLEX Relevance
CAUTI prevention is a Joint Commission quality measure and high-yield NCLEX topic. Prevention beats treatment.