CAUTI Maintenance K-Card

HAC SPS Bundle Elements


Which department are you completing this survey for?

Name of the employee observed:

Patient MRN?


Was a closed drainage system maintained?

If breaks in aseptic technique, disconnection, or leakage occur, replace the catheter and collecting system using aseptic technique and sterile equipment.


Was perineal hygiene completed at minimum daily?

Perform with soap and water or bath wipes.


Was the urine collection bag hanging below the bladder?

Do not rest bag on floor.


Was the catheter and collecting tube free from twists and/or kinks to allow urine to free flow?

Was there a daily discussion of catheter necessity among bedside and medical care team members during rounds?

Remove catherter when longer needed per nurse protocol.


Comments

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