Preventing Catheter-Associated Urinary Tract Infection in the Emergency Department: Tales from the Front Door

Monday, 9 November 2015: 10:20 AM

Nancy A. Hagerman, BSN, RN, CEN
Emergency Department, Flagstaff Medical Center, Flagstaff, AZ, USA

Catheter associated urinary tract infection (CAUTI) prevention begins when the patient enters the healthcare system. Emergency Department nursing staff does not typically envision themselves participating in CAUTI prevention except during urinary catheter placement by using strict sterile technique. The Emergency Department staff led by the Clinical Educator and a staff nurse champion joined the CAUTI prevention effort at our hospital by educating staff regarding CAUTI prevention practices and trialing a new indwelling urinary catheter kit which contained CAUTI prevention products, including a large orange sticker placed on the drainage collection bag indicating date and time of insertion. Staff feedback was positive, and the recommendation was made to use the new kit throughout the hospital. The Emergency Department Clinical Educator participated in policy development for a new indwelling urinary catheter paradigm: reduction of placement indications, increased use of bladder scanning and straight catheter bladder decompression, and nurse driven protocols for discontinuation. The Emergency Department Clinical Educator also developed an education program and badge cards for patient care technicians who had previously never been allowed to participate in indwelling urinary catheter management and emptying. In addition, all nursing staff were re-educated regarding use of the bladder scanner and straight catheter protocol and techniques for bladder decompression. The Emergency Department demonstrated that they are key participants in a hospital-wide CAUTI prevention effort.


Agency for Healthcare Research and Quality. (2014). On the CUSP: stop CAUTI implementation guide.  Retrieved from

Halm, M. A. & O’Connor, N. (2014). Do system-based interventions affect catheter-associated urinary tract infection? American Journal of Critical Care, 23(6), 505-509.