Catheter Associated Urinary Tract Infection Surveillance

1
QUESTIONS AND ANSWERS
2
A patient is admitted to the surveillance
specialty with a catheter in situ Are they
included in CAUTI surveillance?
3
NO
With the exception of patients who have a
catheter inserted in AE or theatre prior to
being admitted to the specialty
4
A patient is undergoing treatment for a UTI
and has a urinary catheter insertedAre they
included in the CAUTI surveillance?
5
NO
Patients are excluded from CAUTI surveillance if
they are undergoing treatment for a UTI at the
time the catheter is inserted
6
A patient had a catheter removed and 2 days
later they develop signs and symptoms for UTI Do
they have a CAUTI?
7
YES
A UTI is considered to be catheter associated if
the patient had a catheter removed within the
three days prior to the onset of the UTI
8
A patient is observed in surgical ICU or HDU
following surgery and prior to admission to a
surgical ward Are they included in CAUTI
surveillance?
9
If the ICU/HDUs are considered part of the
chosen specialty and the patient population has
been defined to include these wards when
surveillance starts
10
A patient has a catheter inserted in theatre
before transfer to the surveillance
specialty Are they included in the CAUTI
surveillance?
11
YES
Patients who have a catheter inserted in AE or
theatre prior to being admitted to the specialty
are included
12
Patient has a catheter inserted on day 2, the
catheter is removed on day 5 and the patient is
discharged on day 6 What is the reason for
ending surveillance?
13
Discharged

• Surveillance ends
• When a CAUTI is diagnosed
• The catheter is removed 3 day follow-up
• The patient is discharged, transferred or died
• or
• The 30 day surveillance period ends
• Whichever is first

14
A patient has a catheter inserted. 5 days later
the catheter is removed and immediately
replaced Is this considered to be a new or
continuous catheterisation?
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Continuous catheterisation
Any catheter replaced within 24 hours of removal
of the previous catheter is a continuous
catheterisation
If the interval between catheter removal and
catheter replacement is more than 24 hours, a new
period of catheterisation should be started
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Following catheter removal, for how many days
should the patient be followed up?
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3 days
Unless they are discharged, transferred or die,
develop a CAUTI or the 30 day surveillance period
ends before the end of the 3 day follow up period
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What date should be recorded as the Date of
CAUTI onset?
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The day the first positive urine specimen is
taken OR The day the physician diagnoses the
CAUTI and institutes antibiotics
20
A patient is admitted under Geriatric Medicine,
however due to bed space they are nursed on the
chosen specialty, e.g. General Medical Are
they included in surveillance?
21
NO
Patients not admitted to the chosen specialty
but nursed in a ward designated to the chosen
specialty are not included in CAUTI
surveillance If in doubt, refer to the
Consultants specialty e.g. Geriatrician or Medic
22
A patient admitted to the chosen specialty e.g.
General Medical is nursed on a ward not
allocated to that specialty e.g. Geriatric
Medicine. Are they included in surveillance?
23
NO
Patients are excluded if they are nursed on
wards not allocated to that specialty
24
A patient is admitted to the surveillance
specialty and has a catheter inserted on
admission (Day 1).The following day (Day 2) this
patient presents with a fever, loin tenderness
and the physician diagnoses a UTI and prescribes
antibiotics
Does the patient meet the criteria for a CAUTI?
25
NO

• The first positive urine specimen must be taken
  or physician diagnosis of UTI must be more than
  48 hours after the catheter was inserted

26
A patient admitted to the chosen specialty e.g.
Geriatric Medicine, due to bed space they are
transferred to General Medical for 6 hours. They
are then transferred back to Geriatric
Medicine When does surveillance end?
27
Surveillance ends when the patient is
transferred to the General Medical ward. On
return to the Geriatric Medical ward the patient
is excluded from surveillance as there is a
catheter in situ on admission.
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A patient has a catheter inserted, it is removed
4 hours later Are they included in CAUTI
surveillance?
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NO
Patients are excluded if the indwelling catheter
is in situ for less than 6 hours
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A patient has intermittent catheterisation Are
they included in surveillance?
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NO
Patients are excluded if the catheter is
intermittent
32
A patient is transferred to the surveillance
specialty where a catheter is inserted. Transfer
notes state that the patient had a catheter in
situ previously and it was removed 5 days prior
to transfer. Does the patient meet the criteria
for a Previous Period of Catheterisation
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YES
A patient who has has a previous catheter removed
more than 24 hours but less than 7 days before
the insertion of the present catheter meets the
criteria for Previous Period of Catheterisation
34
A patient is admitted under Geriatric Medicine,
however due to bed space they are nursed on the
chosen specialty, e.g. General Medical Are
they included in the Admission Data?
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NO
Patients who are not from the chosen specialty
but are nursed in a ward designated to the
chosen specialty are not included in the
Admission Data