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Reducing catheter-associated urinary tract infections through best practice: Sherwood Forest Hospitals' experience

10 January 2019
Volume 28 · Issue 1


A programme to standardise catheterisation practice was introduced in Sherwood Forest Hospitals NHS Trust in 2016, with the aim of reducing the incidence of catheter-associated urinary tract infections (CAUTIs). The initiative involved the use of a catheterisation pack (Bard®Tray). Within the first year following its introduction, the CAUTI rate had been reduced from 13.3% to 2.1% (between July 2016 and June 2017), which is a reduction of more than 80%. Standardisation has also brought cost savings for the Trust of about £33 000 a year. The Trust has maintained its standardisation approach and CAUTI rates remain at around 2%.

Essential to the prevention of catheter-associated urinary tract infections (CAUTIs) is adherence to best catheterisation practice (Royal College of Nursing, 2012; Loveday et al, 2014) across a healthcare setting, which must be continually monitored and reinforced. Owing to time constraints in secondary care, individualised instances of suboptimal catheterisation practice may occur. When staff are continually working in a high-pressure environment with limited time resources, such instances of suboptimal practice may become increasingly frequent, leading to poor patient outcomes.

Sherwood Forest Hospitals NHS Foundation Trust covers three hospitals sites at King's Mill, Newark and Mansfield. In 2014, the Trust's senior teams became aware that catheterisation outcomes within the Trust were suboptimal. This was identified after a locally applied Commissioning for Quality and Innovation (CQUIN) was put in place to aid the reduction of CAUTI-related bloodstream infections (BSIs). The themes identified from this work informed the senior teams that catheter management was suboptimal.

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