CAUTI Prevention

Mommy_of_3_in_AL..RN · Apr 14, 2009

Looking for help with developing a new house-wide infrastructure:
- Is it a good policy to use a bladder scanner before inserting a foley?
- Should all chemo patients have an indwelling foley if they are incontinent?
- What is the best type/brand of catheter securement device?
- Does anyone know anything about sending an automatic specimen when placing a foley within 48H admission in order to
r/o nosocomial UTI?
Any assist with protocol sharing would be appreciated. Thanks.

1. Bladder scanner..we dont have a policy, but it depends on the patient. A patient who retains a lot of urine on a regular basis should, IMO be scanned first in order to make sure that there is a need for the cath, and that you arent just opening them up to infection for no reason. Same goes for renal failure patients that arent making any urine..why would they need a foley if there is nothing to put out?? I think these are more for patients who are being quick cathed. If the plan is to place an indwelling, well..you will see what is there when you place it.

2. I dont think any patient should be cathed just for incontinence reasons. There is too much risk for infection, when they could simply use a brief. Cathethers should be placed in patients that are having strict intake/output measurments, have trouble getting urine to pass, or are on bedrest (after surgery, etc). Noone should be cathed just because the staff doesnt want to change linens/briefs, etc.

3. We use the stat-lock..thats the only one i am familiar with, and i see no problems with it. In fact, we get our tail chewed if we have a patient with a foley that doesnt have a stat lock in place.

4. If i am not mistaken, we automatically get a UA on patients at the time of the cath..better safe than sorry..and if you are already going to cath them, its easier to get the sample then, rather than wait until the cath has been there a while..because if they came in with an infection, i sure dont want to be blamed for them getting one.