In any case, failure to understand the seriousness of the Foley keeps providers from considering the negative impact on sedentary patients' muscles and strength when their ability to move is constrained.
"I think we need to reframe the discussion," Saint says. "Rather, we should think about catheter use in terms of enhancing patient mobility."
Maybe, in addition to having penalties for 30-day mortality or 30-day readmissions, there should be a 30-day fall rate or 30-day pressure ulcer rate for patients who had or have catheters, I suggested.
"From a patient's perspective, that's exactly what they would want," Saint replies. "A lot of hospitals are concerned about falls that occur during hospitalization because that's a medical-legal risk they incur.
"We worry about falls that occur during hospitalization, but from the patient's perspective, it doesn't matter if they fall during hospitalization, or during their nursing home stay, or at home. A fall… is a fall… is a fall, with potential consequences including grave ones like hip fracture. Or even death," he says.
And then, there are the federal financial incentives, which have all but ignored the hospital-acquired CAUTI.
It didn't start out that way. CAUTIs were among the original eight hospital-acquired conditions, for which Medicare would not reimburse hospitals under authority of a 2005 law as of Oct. 1, 2008. But in fact, very few hospitals have failed to recapture reimbursement for extra CAUTI-necessitated care.