Urinary tract infections (UTIs) are the most common nosocomial infection; accounting for up to 40% of infections reported by acute care hospitals. Up to 80% of UTIs are associated with the presence of an indwelling urinary catheter. Catheter associated urinary tract infections (CAUTIs) represent the largest proportion of healthcare associated infections (HAI). Catheter-associated urinary tract infection (CAUTI) increases hospital cost and is associated with increased morbidity and mortality .CAUTIs are considered by the Centers for Medicare and Medicaid Services to represent a reasonably preventable complication of hospitalization. As such, no additional payment is provided to hospitals for CAUTI treatment-related costs.CAUTIs can lead to complications including cystitis, pyelonephritis, gram-negative bacteremia, prostatitis, epididymitis, septic arthritis, endophthalmitis, urosepsis and even death (Centers for Disease Control [CDC], 2009). The Centers for Medicare and Medicaid Services (CMS) considers CAUTI a preventable complication and no longer reimburses for the extra costs of treatment (CMS, 2010). Nursing as a profession has an interest in following the best evidence based practice to improve outcomes and decrease cost, including reducing CAUTIs. The indwelling urinary catheter increases access of micro-organism to the bladder and inhibits complete bladder emptying. The inflated balloon which keeps the catheter in the bladder allows a small amount of urine to remain un-drained. The catheter itself is a direct route of travel for bacteria, on the inside and outside. Bacteria is more likely to become colonized on the outside of the tube from the meatus.
CAUSES OF CAUTI
1. Estimated costs and length of stay attributable to catheter-associated bacteriuria vary greatly. Only a fraction of catheter-associated bacteriuria episodes come to physicians’ attention.