Don’t insert or leave in place a urinary catheter without an acceptable indication.

While it’s common to insert indwelling urinary catheters for critical care patients, prolonged use can lead to catheter-associated urinary tract infections (CAUTI), urosepsis, increased hospital stays and other complications. Although critical illness can be a legitimate indication for urinary catheter use, daily assessment of urinary catheters is recommended. Some evidence indicates that reminder systems or stop orders in critical care settings can reduce the incidence of CAUTI and catheter duration.
For more information:

American Association of Critical-Care Nurses. Prevention of Catheter-Associated Urinary Tract Infections in Adults. [Internet]. 2015 [cited March 2019].

Association for Professionals in Infection Control and Epidemiology. APIC implementation guide: guide to preventing catheter-associated urinary tract infections [Internet]. 2014 Apr [cited 2016 Oct 14].

Canadian Patient Safety Institute. Hospital Harm Improvement Resource: Urinary Tract Infection [Internet]. 2016 Apr.

Chant, C., Smith, O., Marshall, J., Friedrich, J. Relationship of catheter-associated urinary tract infection to mortality and length of stay in critically ill patients: A systematic review and meta-analysis of observational studies. Critical Care Medicine. 2011;39(5):1167-1173. PMID: 21242789.

Colli J, et al. National trends in hospitalization from indwelling urinary catheter complications, 2001-2010. Int Urol Nephrol. 2014 Feb;46(2):303-8. PMID: 23934618.

Lo, E, et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014 Sep;35 Suppl 2:S32-47. PMID: 25376068.

Meddings J., Rogers M., Macy M., Siant, S. Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients. Clinical Infectious Diseases. 2010 Sept;51(5);5: 550-560. doi: 10.1086/655133 PMID: 20673003.

Miller BL, et al. A multimodal intervention to reduce urinary catheter use and associated infection at a Veterans Affairs Medical Center. Infect Control Hosp Epidemiol. 2013 Jun;34(6):631-3. PMID: 23651896.

Ramanathan R, et al. Urinary tract infections in surgical patients. Surg Clin North Am. 2014 Dec; 94(6): 1351-68. PMID: 25440128.