Strategies to prevent urinary tract infection from urinary catheter insertion in the emergency department.

Urinary catheters are commonly placed in ED patients to manage urine output, provide bladder drainage, and facilitate the care of patients with unstable hemodynamics. Many of these patients are admitted to the hospital for treatment, and the catheter may remain in place for days or during the entire time of hospitalization. There are risks associated with the use of urinary catheters. They can cause such complications as urethritis, urethral strictures, hematuria, and mechanical trauma. Bladder perforation and encrustation of the catheter leading to blockage of the urine flow are other potential problems. One of the most common complications is a urinary tract infection (UTI). UTI accounts for 32% of all health care–associated infections. Eighty percent of these infections are attributable to the use of an indwelling catheter. Use of best practice techniques by emergency nurses can help prevent UTIs from occurring as a result of urinary catheter insertions in the emergency department. The Centers for Disease Control and Prevention (CDC) guidelines for prevention of catheter-associated UTIs (CAUTIs) recommends that hospital personnel and others who take care of catheters should be given periodic in-service training that stresses use of the correct technique and potential complications of urinary catheterization.