2 FactsMany catheters are inserted within the hospital setting.The CDC and AHCPR have guidelines for catheter use.Studies have found that patients have urinary catheters for unjustified purposes:41% patient days for unjustified purposes in Medical ICUs.58% patient days for unnecessary catheters on General Medical Units.
3 Facts (cont.)Various reasons for the foley catheters.Average cost of treating urosepsis is $81.03 per day with average treatment lasting 10 day. Total cost of $ just for medication treatment.Length of Stay can be increased by 3.8 days r/t f/c urosepsis.CDC-NHSN Top Docile Bench mark: 0 foley related UTI in 1000 catheter days
4 Indwelling foley catheters are a major source of UTI’S. Direct relationship between duration a f/c is in the patient and incidence of infection.Risk factors:FemaleAdvanced ageDurationDiabetesRenal insufficiency
6 Bacteria is a function of time with a f/c: Single event – risk < 1%4 days – risk increases to 30%30 days – risk %
7 Risks/Consequences UTI PYELONEPHRITIS DEATH R/T BACTEREMIA DAMAGE TO URETHRA (SCARRING AND STRICTURES)Prostatitis and epididymitis
8 What we are doing now that is the right thing to do What we are doing now that is the right thing to do. Foley Catheter BundleWhat is the Foley Catheter Bundle?Insert using sterile techniqueHand hygiene before and after any contact with the F/C systemSecure catheter to thigh at ALL timesKeep catheter bag below the level of the bladder at ALL timesMaintain a sterile, continuously closed systemSpecified criteria for insertion and continuation of a foley catheterPeri care daily and after all incontinent stoolWhat is “Peri Care” for a patient with a f/c? Daily wash with warm soap & water then dry.
9 Criteria for insertion and continuation of the foley catheter RetentionCritical I&OComatoseParalyzedNeurogenic BladderPre-op placementWound with incontinenceBladder IrrigationPhysical traumaPain with bedpan/incontinence briefTerminal illness/comfort measures“other”
10 Questions:True or False:A F/C UTI can occur by 30% within 4 days of placementIncontinence is a reason to place a F/C
11 The F/C Bundle includes: Hand hygiene before & after any contact with the F/C systemInsert using sterile techniqueSecure F/C to thigh at ALL timesKeep catheter bag below level of bladder at ALL timesMaintain a sterile continuously close systemPeri care daily & after any incontinent stoolSpecified criteria for insertion & continuation of a F/CAll of the above
12 Criteria for insertion and continuation of a F/C includes: RetentionCritical I&OComatoseParalyzedNeurogenic BladderPre-op placementWound with incontinenceBladder IrrigationPhysical trauma/pain with bedpan/incontinence briefTerminal illness/comfort measuresAll of the above