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Updated: Nov 10, 2025
An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
Published on: June 24, 2025
A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit
Holly N Shadle1, Valerie Sabol2, Amanda Smith3
1Holly N. Shadle is a nurse practitioner, Neurosurgery Department, Neuroscience Center, UPMC Susquehanna, Williamsport, Pennsylvania.
Insights
A bundled intervention eliminated catheter-associated urinary tract infections in an intensive care unit. This approach, including education and protocols, shows promise for preventing these common healthcare infections.
Area of Science:
- Healthcare-associated infections
- Critical care medicine
- Patient safety
Background:
- Catheter-associated urinary tract infections (CAUTI) are a common healthcare-associated infection, particularly in intensive care units (ICUs).
- These infections significantly increase patient morbidity and healthcare expenditures.
- The target institution exceeded its CAUTI benchmark, with six events in the ICU in 2018.
Purpose of the Study:
- To implement and evaluate a bundled intervention to reduce CAUTI in an ICU setting.
- Objectives included a 30% reduction in CAUTI, a 20% decrease in urinary catheter days, and 75% compliance with catheter documentation.
Main Methods:
- A pre-post study design was employed over two 4-month periods.
- Interventions included staff education, an electronic daily checklist, and a nurse-driven urinary catheter removal protocol.
- The study population comprised critically ill adult patients in the ICU.
Main Results:
- No CAUTI events were reported during the intervention period, a reduction of 1.33 per 1000 catheter days.
- Documentation compliance significantly improved from 50.0% to 83.3% (P = .01).
- A non-significant 10.5% increase in catheter days was observed (P = .12).
Conclusions:
- A bundled intervention strategy effectively eliminated CAUTI in the ICU.
- This approach demonstrates potential for preventing healthcare-associated infections in critical care.
- The intervention's success suggests adaptability for other infection types.
Background:
Catheter-associated urinary tract infections are the second most common health care-associated infections, occurring most frequently in intensive care units. These infections negatively affect patient outcomes and health care costs.
Local Problem:
The targeted institution for this improvement project reported 13 catheter-associated urinary tract infections in 2018, exceeding the hospital's benchmark of 4 or fewer such events annually. Six of the events occurred in the intensive care unit. Project objectives included a 30% reduction in reported catheter-associated urinary tract infections, 20% reduction in urinary catheter days, and 75% compliance rating in catheter-related documentation in the intensive care unit during the intervention phase.
Methods:
This project used a pre-post design over 2 consecutive 4-month periods. The targeted population was critically ill patients aged 18 and older who were admitted to the intensive care unit. A set of bundled interventions was implemented, including staff education, an electronic daily checklist, and a nurse-driven removal protocol for indwelling urinary catheters. Data were analyzed using mixed statistics, including independent samples t tests and Fisher exact tests.
Results:
No catheter-associated urinary tract infections were reported during the intervention period, reducing the rate by 1.33 per 1000 catheter days. There was a 10.5% increase in catheter days, which was not statistically significant (P = .12). Documentation compliance increased significantly from 50.0% before to 83.3% during the intervention (P = .01).
Conclusions:
This bundled approach shows promise for reducing catheter-associated urinary tract infections in critical care settings. The concept could be adapted for other health care-associated infections.
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