Don’t place, or leave in place, urinary catheters for incontinence or convenience or monitoring of output for non–critically ill patients (acceptable indications: critical illness, obstruction, hospice, perioperatively for &lt; 2 days for urologic procedures; use weights instead to monitor diuresis

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Rationale and Comments

Catheter-associated urinary tract infections are the most common (frequently occurring) health care–acquired infection. Use of urinary catheters for incontinence or convenience without proper indication or specified optimal duration of use increases the likelihood of infection and is commonly associated with greater morbidity, mortality and health care costs. Published guidelines suggest that hospitals and long-term care facilities should develop, maintain, and promulgate policies and procedures for recommended catheter insertion indications, insertion and maintenance techniques, discontinuation strategies, and replacement indications.

Sponsoring Organizations

Society of Hospital Medicine (Adult)

Sources

IDSA guideline, Joint Commission

Disciplines

Urologic

References

Hooton TM, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults. Clin Infect Dis. 2010;50(5):625-63.
Saint S, et al. Catheter-associated urinary tract infection and the Medicare rule changes. Ann Intern Med. 2009;150(12):877-84.
Centers for Medicare & Medicaid Services,Joint Commission.Standards for hospital care, surgical Care Improvement Project (SCIP), SCIP-Inf-9; Performance measure name: urinary catheter removed on postoperative day 1 (POD 1) or postoperative day 2 (POD 2) with day of surgery being day zero. 2013. 2013 Joint Commission National Hospital Inpatient Quality Measures Specification Manual, version 4.11.