An increase in the number of catheter days for each patient is associated with an increase in the number of CAUTIs, or catheter-associated urinary tract infections, as well as other complications. That has prompted hospital infection control teams to step up efforts to remove catheters no longer needed and not insert them unless they're absolutely necessary.
Additionally, the Centers for Medicare & Medicaid Services no longer reimburses hospitals the additional cost of caring for a patient with a urinary tract infection and has set a goal to reduce CAUTI by 25% by next year.
Urinary catheters were said to be appropriate for urinary tract obstruction, neurogenic bladder, urologic study or surgery on contiguous structures, sacral pressure ulcer (stage III or IV) with incontinence, and end of life care.
The interventions in the Michigan project included educating clinicians about the use of catheters, including distribution of "Bladder Bundle" manuals that included step-by-step description of the process, and of making sure to take daily assessments of catheter necessity during nursing rounds.
However, the Michigan researchers said that not all the hospitals improved their rates at the same pace or to the same extent.