Preventing CAUTI through catheter necessity review

Start before infection is suspected

CDC recommends urinary catheters only for appropriate indications and only as long as necessary; they should not substitute for incontinence care.^[1] Necessity review therefore begins with the insertion decision. Removal or an alternative approach still requires clinical assessment and an approved local process.

Connect the whole pathway

CDC emphasises aseptic insertion with sterile equipment, a closed drainage system and removal once the catheter is no longer needed.^[2] Treat these as a continuing pathway, including transfers between wards, rather than a checklist completed only at insertion.

A practical review process

ICORP suggests making the indication and review plan visible to every shift. Include necessity in handover or ward rounds and identify whom to contact when the indication is unclear. Pilot in a defined patient group. Staff should not remove devices outside their authority or an approved clinical protocol.

Measure use as well as outcomes

CDC describes surveillance measures using catheter-days and catheter utilisation.^[1] If adopted, keep definitions and counting methods consistent. An additional editorial suggestion is to review reasons for prolonged use. A positive urine culture alone should not replace appropriate clinical assessment or the selected surveillance definition.