Never Event #4: Catheter Associated Urinary Tract Infections
Catheter related urinary tract infections are the most frequently encountered infection amongst people in nursing homes. Generally, the longer a catheter is in place, the more likely an infection will develop. According to the Centers for Disease Control and Prevention (CDC), infection rates range from 1% to 5% after a single brief catheterization to virtually 100% rate of infection for long-term catheter uses.
The urinary tract is composed of the kidneys and urethra. As a rule, the ‘higher up’ the infection, the more serious it is. A lower urinary tract infection affects the urethra and bladder and can usually be treated easily with antibiotics. An infection in the upper urinary tract is more severe and affects the kidneys (pyelonephritis) and requires extensive medical treatment. Once a urinary tract infection reaches the kidneys, it must be closely monitored or it may spread to other areas of the body. An advanced urinary tract infection may result in kidney failure and death.
What are the symptoms of a catheter associated urinary tract infection?
- Painful urination
- Tenderness above the pubic bone
- Decreased appetite
- Inbalance, frequent falls
- Increased heartbeat
If there is such a high rate of infection, why is a catheter associated urinary tract infection on the ‘never list‘?
Most urinary tract infections are preventable with the implementation of basic sanitation. Further, upper urinary tract infections are preventable with early detection and treatment. Below are safeguards recommended by the CDC:
- Provide education to hospital and nursing home staff on proper catheter insertion technique
- Only catheterize when necessary
- Wash hands
- Use sterile equipment
- Use closed drainage bags
- Take regular urine samples
- Observe the color, clarity, and smell of draining urine
- Keep residents with urinary tract infections separate from other non-infected residents
As you can see, most of the prevention guidelines are extremely basic, There is no excuse for facilities that fail to implement of urinary tract infection prevention techniques.