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What risk factors should my nurses watch for to identify patients who may have a catheter-associated urinary tract infection (CAUTI) present on admission (POA)?

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Nurses must work closely with all members of the healthcare team to identify patients at high risk for CAUTI, and carefully and accurately document findings in patients' medical records. These intraprofessional team members must also share the opinion that the best means of preventing CAUTI is to reduce catheter use whenever possible.

Starting with comprehensive patient histories on arrival is essential to identify patients' risk factors for developing a CAUTI or to determine whether they already have a UTI on admission.

According to current findings in the literature and a record review of patients with CAUTI, the following are risk factors:

  • Gender (e.g., women are more likely to have UTIs than men)
  • Advanced age
  • History of urinary tract problems (e.g., enlarged prostate or urologic surgery)
  • Neurologic conditions (e.g., spinal cord injury) causing neurogenic bladder problems
  • Previous UTIs
  • Previous and/or current abnormal voiding patterns
  • Current catheter history
  • Incontinence
  • Comorbid conditions such as diabetes
  • Immunosuppression

-June Marshall, RN, MS, NEA-BC, Lucy Bird, RN, and Laura Maverick, BSN, RN-BC

(August 2009)