Reflective accounts

Preventing CAUTIs

A CPD article improved Rebecca Keown’s knowledge of catheter-associated urinary tract infections
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A CPD article improved Rebecca Keowns knowledge of catheter-associated urinary tract infections

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The CPD article discussed the symptoms of catheter-associated urinary tract infections (CAUTIs), the risks involved with catheter use and how to manage catheters safely.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

Reading the article has helped me to understand that CAUTIs are a common problem in hospital and community settings. I have learned that the bladder has few defences against infection. The most important mechanism it has is the flushing action that occurs when voiding urine, which eliminates bacteria. Having a urethral catheter in situ increases the risk of developing a CAUTI because

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A CPD article improved Rebecca Keown’s knowledge of catheter-associated urinary tract infections


CAUTIs are common in hospitals and the community  Photo: SPL

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The CPD article discussed the symptoms of catheter-associated urinary tract infections (CAUTIs), the risks involved with catheter use and how to manage catheters safely.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

Reading the article has helped me to understand that CAUTIs are a common problem in hospital and community settings. I have learned that the bladder has few defences against infection. The most important mechanism it has is the flushing action that occurs when voiding urine, which eliminates bacteria. Having a urethral catheter in situ increases the risk of developing a CAUTI because the catheter interferes with this mechanism.

I am now aware that patients aged over 65 are at greater risk of developing a CAUTI. Most of the patients in the practice where I work are over 65, and many of them also have diabetes, chronic wounds and are immunosuppressed, all factors that result in a greater risk of developing a CAUTI.

Having read the article, I now feel confident in identifying the signs and symptoms of a CAUTI. The article stated that these signs and symptoms can differ in older adults. For example, individuals might become more restless and disorientated, or experience increased agitation. In addition, older adults may not develop pyrexia, which is usually a sign of infection.

I have learned that other signs and symptoms of a CAUTI include tachycardia, passing urine more frequently, abdominal pain, pain passing urine and urine appearing cloudy and darker in colour.

How did you change or improve your practice?

If I observe any of the signs and symptoms of a CAUTI, I will obtain a urine specimen from the patient, and test the urine using reagent strips. The presence of leucocytes and, in severe cases, blood, indicate infection. I have assisted in the diagnosis of a CAUTI on several occasions after observing a patient’s symptoms, as described in the article.

The article explained that documentation and record keeping can be suboptimal for older patients, and I have observed incomplete documentation in my clinical area. I will ensure I complete the relevant documentation in relation to catheter insertion, including when and why the catheter was inserted. I will ensure that I complete a care plan and update it regularly.

I am aware that catheters made from plastic or latex are not suitable for long-term use, because they are irritants, and many patients are allergic to latex. Therefore, in future I will consider appropriate catheter selection, especially when a long-term catheter is required. I also understand that alternatives to urethral catheters are available, for example external drainage systems.

How is this relevant to the Code?

Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

One theme of The Code is to preserve safety, which includes adhering to recommended practice in relation to controlling and preventing infection. The article is relevant to this theme because it discusses safe management of an indwelling catheter, which helps to reduce the risk of CAUTI development.

The article also discussed ways of preserving patients’ dignity if they have an indwelling catheter, which is crucial to the theme of prioritising people.

Rebecca Keown is a nurse practitioner at Liverpool Community Health NHS Trust


This reflective account is based on NS818 Gould D (2015) Preventing catheter-associated urinary tract infection. Nursing Standard. 30, 10, 50-59

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