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Table 3 Evidence base for No CAUTI Bundle

From: Avoiding inappropriate urinary catheter use and catheter-associated urinary tract infection (CAUTI): a pre-post control intervention study

N NEED for catheter assessed – refer to indications, scan bladder, consider alternative, document indication. - Need for IUC is assessed - appropriate indications for insertion [7, 47, 48]. - Scan the bladder to determine bladder volume [7] - Consider alternatives such as external sheath (males),intermittent catheterisation by staff/patient, SPC, double voiding, commode, timed toileting [7, 47, 48]
O OBTAIN patient consent, OFFER patient education including hygiene. - Obtain patient consent and importance of accurate complete documentation. - Provide written and verbal information to patient/carer [49] - Ensure daily meatal hygiene is performed as part of personal hygiene, soap and water is all that is required [7, 47, 48]
C COMPETENCY – clinicians who insert catheters must have documented competency - Competent and trained staff should insert catheters [7, 48]
A ASEPSIS – maintain asepsis & hand hygiene during insertion and while catheter is in place. - Aseptic technique and sterile equipment must be used for IUC insertion. Hand hygiene “Moment 2” and non-sterile gloves is recommended when manipulation of the IUC or drainage system is required. - Empty the bag when ¾ full and use a clean container for each patient; avoid contact between outlet and container. - Maintain a sterile closed system of drainage [7, 48]
U UNOBSTRUCTED flow – no kinks or loops, catheter secured, bag below bladder level and off the floor. - Unobstructed continuous urine flow with no kinks or loops, bag below the bladder and not in touch with any surface. Secure the catheter to the patient to minimise movement and trauma and improve patient comfort [7, 48]
T TIMELY catheter removal and documentation – may be nurse initiated. - Timely removal of the IUC - daily review. Nurse initiated removal guidelines followed if there is no medical documentation for continued use [7, 48]
I INFECTION risk – daily periurethral hygiene. Collect urine specimen only when clinically indicated. - Infection and catheter specimen urine (CSU) collection: must be collected using aseptic technique, from a newly inserted catheter and before the commencement of antimicrobials - CSU should only be collected if clinically indicated [7, 47, 48]