Which action will you take to most effectively reduce the incidence of hospital-associated urinary tract infections?
A. Ensure that clients have enough adequate fluid intake
B. Teach assistive personnel how to provide good perineal hygiene
C. Perform dipstick urinalysis for clients with risk factors for UTI
D. Limit the use of indwelling foley catheter (IFC)
Correct Answer: D. Limit the use of indwelling foley catheter (IFC)
The most effective way to reduce the incidence of UTIs in the hospital setting is to avoid using retention catheters. Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay. The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter.
Option A: Adequate fluid intake may improve the symptoms of UTI, however, it can help mildly with the prevention of hospital-acquired UTI. The DRInK-Up study provides preliminary evidence suggesting that increasing daily fluid intake by small amounts may have a potentially positive effect on the number of UTIs experienced. However, further research is still needed.
Option B: Routine hygiene of the urethral meatus surface should be performed during daily bathing or showering. Urethral cleaning with povidone-iodine solution or soap and water has not been shown to prevent CA-UTIs. However, there is evidence that frequent urethral cleaning can lead to mucosal irritation and breakdown that may increase the risk of infection.
Option C: Avoid breaking the collecting system to obtain urine specimens for analysis and bacterial culture. To obtain urine specimens, the sampling port for the urine collection must be used. If this is not available, urine can be aspirated with a sterile needle and syringe from the distal end of the catheter using an aseptic technique.