Catheter Associated Urinary Tract Infections (CAUTI)

A urinary tract infection is an infection that can occur in the kidneys, in the tubes that take urine from the kidneys to the bladder, or in the bladder. An indwelling urinary catheter is a tube placed inside the bladder that drains urine to a bag outside the body. Some patients need urinary catheters to help monitor and treat certain conditions; for example, patients who are critically ill and require close monitoring, patients who are recovering from surgery and patients who cannot pass urine. Patients who have indwelling urinary catheters are more likely to get a urinary tract infection.

JFK uses evidence based best practices to reduce the chance of CAUTI. Interventions to reduce CAUTI include maintaining aseptic technique when inserting a catheter, using a separate emptying container for each patient, and using a device to secure the catheter tubing to a patient’s leg. In addition, each day the critical care nursing staff reviews the need for the catheter on every patient and discusses removal or alternatives with the physician when the catheter is no longer needed.

What are we measuring?

The rate of patients with catheter associated urinary tract infections in the critical care units (ICU and CCU).

Note: Hospitals and other websites use different ways to calculate rates. We calculate rate using 1000 catheter days as the denominator and the number of CAUTIs as the numerator.

2016Q4 Cauti 1

What is our performance telling us?

The critical care graph shows the occurrence of CAUTI in the critical Care units over time on a slight downward trend. It is our goal to eliminate CAUTI. In September 2016, we experienced an increase in the rate. With daily focus on the need for these catheters and proper maintenance, the rate dropped the next month. 

CAUTI rates may be reported on public websites such as Hospital Compare; different periods for reporting data can show different rates of CAUTI. The graph above shows rates through December 2016. 

What are we measuring? 

In addition to critical care alone, we measure the combined monthly occurrence of CAUTI in critical care and medical surgical patient care units. 

2016Q4 Cauti 2

Note: Hospitals and other websites use different ways to calculate rates. We calculate rate using 1000 catheter days as the denominator and the number of CAUTIs as the numerator.

Beginning January 2016 the Hospital Compare website began reporting a CAUTI metric for medical and surgical as well as critical care patient units. The graph above displays that data. There is a slight upward trend. A multidisciplinary team reviews each occurrence to look for additional opportunities to eliminate CAUTI.

Hospital Compare uses a standardized infection ratio to report CAUTI.

The graph below shows that JFK has lower (better) SIR than the National SIR for critical care and medical surgical patient care units combined.

2016Q4 Cauti 3

What is our performance telling us? 

It is our goal to eliminate CAUTI. We use the most current best practice guidelines to improve our processes and continue to work to reduce and ultimately eliminate CAUTI. Every day the nurses and physicians review the need for continuing these catheters and discuss whether the catheter can be removed. In addition, a team reviews each CAUTI individually to determine the cause and identify ways to reduce CAUTI.

What can you do to prevent a CAUTI?

  • If you do not see your providers clean their hands, ask them to do so.
  • Always keep your urine bag below the level of your bladder.
  • Do not tug or pull on the tubing.
  • Do not twist or kink the catheter tubing.
  • Ask your healthcare provider each day if you still need the catheter.