Reducing CAUTI incidence: A multimodal and multidisciplinary approach for improved prevention and patient outcomes.

Abstract

Background: Catheter-associated urinary tract infections (CAUTIs) are common health care-associated infections and a key quality metric tied to patient safety. Although the standardized utilization ratio (SUR) declined, CAUTI rates remained above the target benchmark at a large academic trauma facility, prompting a multidisciplinary quality improvement initiative.

Methods: A multidisciplinary team implemented a multimodal approach targeting indwelling urinary catheter practices. Interventions included standardized urine culture protocols, education on dependent loop prevention, 2 person insertion procedures, and monitoring indwelling urinary catheter order compliance. Data on 6 key metrics were tracked facility-wide from 2023 to 2025.

Results: Urine culture card compliance improved from 15.4% to 100%. Indwelling urinary catheter order compliance rose from 50% to 85%, and 2 person insertion documentation reached 93%. The SUR dropped from 0.903 (2021) to 0.68 (2024), while CAUTI SIR decreased from 0.564 (2021) to 0.284 (2024). Current 2025 YTD SIR is 0.168.

Discussion: Standardizing catheter care by implementing evidence-based interventions resulted in preventing CAUTI. To maintain these positive outcomes, leadership support, collaboration across disciplines, and ongoing education were crucial.

Conclusions: A system-wide, multimodal CAUTI prevention strategy significantly reduced catheter use and infection rates. Continued focus on education and compliance tracking is essential to achieve and sustain zero harm.