CAUTI Insertion K-Card

HAC SPS Bundle Elements


Which department are you completing this survey for?

Name of the employee observed:

Patient MRN?


Did the insertor perform hand hygiene?

Perform hand hygiene immediately before and after insertion or any manipulation of the catheter device or site [CDC Reference] 



Was aseptic technique maintained during insertion?

Use sterile gloves, drape, sponges, and appropriate antiseptic or sterile solution for per urethral cleaning, and a single packet of lubricant jelly for insertion [CDC Reference]


Does the patient meet appropriate CDC clinical indications for urinary catheter use?

Appropriate CDC Clinical Indications for Urinary Catheter: 
-Acute urinary retention (sudden/painful inability to urinate) or bladder outlet obstruction.
-To improve comfort for end of life care if needed.
-Critically ill and need for accurate measurements of I&O. 
-Selected surgical procedures (GU Surgery/Colorectal surgery)
-To assist in healing of open sacral or perineal wounds in incontinent patients
-Need for intraoperative monitoring of urinary output during surgery or large volumes of fluid/diuertics anticipated
-Prolonged immobilization (potentially unstable thoracic of lumbar spine, multiple traumatic injuries e.g. pelvic fractures)

 


Comments

If any No is chosen above, please provide more details.