Joint Commission explains safety goals on UTIs caused by catheters

The Joint Commission has released a report offering the rationale behind its updated safety goals on catheter-associated urinary tract infections (CAUTIs) for hospitals.

Its report said CAUTIs are the most common type of hospital-acquired infections, with as many as 80 percent of the infections caused by an indwelling catheter in the urethra. The most important factor to consider to limit these infections, according to the commission, is using catheters for shorter amounts of time.

Along with updating standards for hospitals, the same standards will now apply to nursing centers in an effort to reduce hospitalizations.

“An estimated one to three million healthcare-associated infections strike nursing home residents annually, and many of these are infections related to urinary catheters,” said David W. Baker, MD, executive vice president of The Joint Commission’s division of healthcare quality evaluation. “CAUTIs can lead to serious complications and hospitalizations. And, the rate of these infections is even higher for hospital patients. This is why The Joint Commission felt it was important to implement its new National Patient Safety Goal (NPSG) for nursing care centers and an updated goal for hospitals and critical access hospitals to reflect the latest scientific evidence.”

The report cited Agency for Healthcare Research and Quality figures which said 400,000 nursing home residents die every year from healthcare-associated infections.

The new NPSG included several changes to its elements of performance:

• Educate staff and licensed independent practitioners involved in the use of indwelling urinary catheters about CAUTI and the importance of infection prevention.
• Develop written criteria, using established evidence-based guidelines, for placement of an indwelling urinary catheter.
• Follow written procedures based on established evidence-based guidelines for inserting and maintaining an indwelling urinary catheter.
• Measure and monitor CAUTI prevention processes and outcomes in high-volume areas.

Guidelines for CAUTIs are nothing new. The Centers for Disease Control and Prevention first published materials about preventing those infections in 1981. CAUTIs are among eight conditions which CMS has identified as having “evidence-based prevention guidelines,” which if hospitals don’t follow, can result in reduced reimbursement.