Blamed for CAUTI

Okay, I am no Infection Control specialist, but from the reading I have done this evening I believe the person who told you this may be confused. They may be able to qualify this situation as being a HAI (healthcare-associated infection) and it may meet official CAUTI inclusion criteria for reporting purposes based on which "Day of Admission" it is discovered, but the specific mechanisms for such are multiple. I haven't yet come across information about this "3rd day WBC spike." In other words, I see evidence that which day of admission it is helps make the decision whether they must report it as CAUTI or not, but NOT information that "proves" what specific mechanism caused the CAUTI. Still looking...

What "consequence"/punishment has your manager mentioned? Don't sign anything if they are asking you to; don't "entertain" this accusation AT ALL until (unless) you get facts - meaning don't start apologizing and acting defensive, etc. Calmly and pleasantly state that you feel this is very unlikely and ask where (specifically) you might be able to read the information to which your manager refers.

CAUTI can be caused by other things such as organisms from the distal urethra, from urinary retention with catheter in place, from irritation of bladder epithelium, etc., etc., etc. Just because an event "qualifies" as a CAUTI for reporting purposes does NOT by definition mean that it was not inserted using excellent sterile technique. I would want to tell this individual to learn reading comprehension, but (knowing that I'm not an expert and am merely working with common sense and brief research) what I would do instead is ask for her to reference her "facts".

Good luck!

It depends on when it was inserted and when the infection was found. In my hospital, the patient has to be on our unit for 72 hours before the CAUTI is charged to us. So, if a culture was obtained in 48 hours, the CAUTI would be charged to the previous unit.

Was the patient tested upon admission to the hospital? Wondering if they came in with it.

It depends on when it was inserted and when the infection was found. In my hospital, the patient has to be on our unit for 72 hours before the CAUTI is charged to us. So, if a culture was obtained in 48 hours, the CAUTI would be charged to the previous unit.

Was the patient tested upon admission to the hospital? Wondering if they came in with it.

Still, none of that (even which unit it is "charged" to) can detail the mechanism of infection.

If I am wrong, I would be sincerely interested in learning the facts.

It all sounds like BS. To blame you, a staff nurse! Makes absolutely no sense. Just say you used sterile techniques, followed hospital policy, etc.

If every patient you catherized got a UTI maybe someone should check out your technique.

Some patients are going to get UTI's after foley insertions even under the most perfect sterile insertions. Yeah I've got a good idea let's blame the nurse!

The recommendations are to reduce the use of or need for foleys, not blame the nurse.

Thank you guys so much for your responses! I will follow up with my manager and ask her for the specific literature they use in assessing these things.

Due to my SO being in the military, I recently relocated from a large university hospital/level 1 trauma ED to a new smaller ED that is all about pinching pennies (I understand...a sign of the times). No mention of any "punishments", but to be the new kid on the block and be perceived as costing the hospital all this money in reimbursement for something I don't understand their rationale for is worrisome/frustrating.

As for the patient, I totally agree! This was a patient with enough co-morbidities that they likely would have gotten a UTI regardless. However, this was placed pre TPA administration so ultimately they required it (at least initially).

I sent an initial urine sample after placing the foley but just reviewed the chart and saw the physician never ordered it to be run- so no initial result. I wish I had caught that and asked the physician about it! Dang it....haha

Thank you all for your support and input...it's alleviating a little of the stress I feel over this situation!

Just curious whether there has been any resolution of this ignorance-based situation.

:) I hope so!