320 Catheter Associated Urinary Tract Infection Prevention Program

Friday, March 19, 2010
Grand Hall (Hyatt Regency Atlanta)
Sameeh Ghazal, MD, MRCPCH , King Fahad Medical City, Riyadh, Saudi Arabia
Syam Clara Viorica, MD , King Fahad Medical City, Riyadh, Saudi Arabia
Ahmed Hakawi, MD , King Fahad Medical City, Riyadh, Saudi Arabia
Mercy Joseph, RN, CIC , King Fahad Medical City, Riyadh, Saudi Arabia
Mohamod Mukahal, RN , KFMC, Riyadh, Saudi Arabia
Background: More than 1 million patients in USA hospitals acquire a urinary tract infection (UTI), with catheter-associated infections being the most common type.

 The number of catheter associated UTIs (CA UTI) in KFMC during 2008 was 85 while the number of urinary catheter days was 22.274.The urinary catheter utilization rate was13.06% and the overal hospital rate of CA UTI was 3.82/1000 urinary catheter-days, with large variability between different departments.

Objective: To decrease the rate of catheter associated UTI (CA UTI) to less than 2 infections /1000 catheter- days in targeted hospital areas.


Catheter Associated UTI Bundle is an intervention that was initiated by Infection control department at the beginning of 2009.This intervention targeted certain hospital areas in KFMC with high utilization rate of urinary catheters and high rate of CA UTI: Neuroscience Centerl and Rehabilitation hospital.

Bundle has two components:

A. Urinary catheter Insertion Bundle, which consists of:

  1. Perform hand hygiene immediately before procedure
  2. Maintain maximum aseptic technique
  3. Use pre-prepared set
  4. Use the smallest suitable catheter size
  5. Experienced personnel should do the procedure(had previously inserted more than 5| catheters)
  6. Secure the catheter properly
  7. Maintain close sterile drainage system

B.CAUTI Maintenance Bundle, which consists of:

  1. Daily review of the need for the urinary catheter
  2. Keep catheter continuously connected to the drainage system
  3. Ensure patients are aware of their role in preventing UTI
  4. Daily meatal hygiene
  5. Empty urinary drainage bags regularly each into a clean container
  6. Hand hygiene before and after manipulating catheters

Study design: interventional study with comparison of infection rates after and before intervention

Study population: patients with indwelling urinary catheters inserted in the assigned departments

Study period: January- December 2009.

The rate of CA UTI and Staff compliance with the bundle were continuously monitored.

Data entry and analysis:

Data has been entered and analyzed by Hospital epidemiology department.

Statistical analysis included:

        Ø      Calculation of infection rates

        Ø      % of UC with optimal insertion care

        Ø      % of UC with optimal maintenance care


The rate of UC UTI in Neuroscience center decreased from 6.98 infections/1000 urinary catheter- days to 1.66 infections/1000 urinary catheter –days and in Rehabilitation hospital decreased from 6.01 infections/1000 urinary catheter- days to 0 infections/1000 urinary catheter- days


The implementation of CA UTI Bundle was very successful in reducing CAUTI to the targeted level in the selected department within short period