A program to limit urinary catheter use at an acute care hospital.

BACKGROUND: Urinary catheters are the major cause of catheter-associated urinary tract infections (CAUTIs) and often may be unnecessary. We attempted to reduce the number of CAUTIs by limiting the use of urinary catheters.

METHODS: The number of catheters and CAUTIs were recorded during a control period of 7 months. A program was implemented limiting these catheters to patients who had urinary tract obstruction, orders for hourly output measurements, breakdown of skin in areas exposed to urine in patients with documented urinary tract infections, or urine- associated skin irritation that was unresponsive to barrier measures. In patients who did not meet these criteria, the physician was asked for a catheter removal order, and superabsorbent pads or diapers were used. Urinary catheter use and CAUTIs were then recorded during a subsequent 5-month intervention period. Nursing personnel were queried regarding their experience after 4 months of the intervention period.

RESULTS: Urinary catheter use decreased by 42% (P < .01), and the incidence of CAUTIs decreased by 57% (P < .05). There was some improvement in nursing satisfaction.

CONCLUSION: Limiting urinary catheter use can reduce the incidence of CAUTI with no deterioration in nursing satisfaction.