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The Joint Commission (TJC) has finalized changes to the National Patient Safety Goal (NPSG) for catheter-associated urinary tract infections (CAUTIs) under NPSG.07.06.01. The standard went into effect January 1 and includes five revised elements of performance.
Hospitals must implement evidenced-based practices to prevent indwelling CAUTIs — one of the most common healthcare-associated infections. The CDC has had guidelines in place since December of 2009. The NPSG was amended, in part, due to changes published by the Society for Healthcare Epidemiology (SHEA), the Infectious Disease Society of America (IDSA), and APIC in the Compendium to Prevent Healthcare-Associated Infections in Acute Care Hospitals.
The NPSG requires staff education on the use of indwelling catheters and CAUTI prevention in addition to ongoing education, an annual skills lab, and competency assessment. TJC allows hospitals to choose their own testing intervals.
Patients and families also must be educated in CAUTI prevention and symptoms. FAQs about Catheter-Associated Urinary-Tract Infection is available for hospital use at http://www.shea-online.org/Assets/files/patient%20guides/NNL_CA-UTI.pdf.
The hospital must develop written criteria on when it is appropriate for patients to have a Foley catheter. For example, criteria could include critically ill patients in which urinary output must be measured. It may be used perioperatively for certain surgeries.
A written policy must dictate how to insert and secure the catheter; maintain sterility of the urine collection system; and proper procedure for collecting specimen. Nursing education should include the revised standards in their education.
The medical record must contain a system of documentation for the use, insertion, and maintenance of the catheter. The hospital must measure and monitor prevention and outcomes.