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Indwelling urinary catheters can serve therapeutic roles when indicated, however, more than 560,000 patients develop catheter associated urinary tract infection (CAUTI) each year, letting patients in higher risk of extended hospital stays, morbidity, mortality, and increased health care costs (America Nurses Association (ANA), 2016). The purpose of CAUTI prevention program is to provide evidence-based practice guidelines for insertion and discontinuation of indwelling urinary catheters to protect patients from infection, trauma, and complications (Emanuel Medical Center, 2015).
This policy attempts to achieve:
(1) a minimal indwelling urinary catheterization period time necessary related to the disease process,
(2) a proper catheter care and maintenance, and
(3) a proper assessment for appropriateness of insertion, continuation, and discontinuation of indwelling urinary catheter.
The CAUTI prevention program policy includes:
(1) standards for insertion and continued use of indwelling urinary catheter,
(2) step-by-step guidelines for aseptic urinary catheterization techniques of male and female patients,
(3) a protocol for catheter care,
(4) indications and instructions for a catheter removal, and
(5) bladder monitoring and interventions after the removal of indwelling urinary catheter (Emanuel Medical Center, 2015).
Clinical Implementations by Registered Nurses
When I had an opportunity to care a patient with indwelling urinary catheter, I could observe that CAUTI prevention policy and its reasoning were generally acknowledged by registered nurses. The policy could be found by both using electronic data base nursing policy search, or from the policy and procedures binders.
Along with sterile catheter insertion techniques and protocols on catheter care, my supervising nurse explained of following nurse-driven protocols to remove catheters. The ‘Nurses driven removal of indwelling Foley catheter protocol' authorizes registered nurses to follow a checklist to make a decision of removing the indwelling urinary catheter within 24 hours without a physician's order, unless contraindicated by patient's condition or physician's discontinuation of the protocol (Emanuel Medical Center, 2015).