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Policy Blog: Five Questions: AUA Releases New CAUTI White Paper

Timothy Averch, MDTimothy Averch, MD
December 1, 2014

The AUA recently published a White Paper on Catheter-Associated Urinary Tract Infections: Definitions and Significance in the Urologic Patient. Timothy Averch, MD, chair of the project workgroup, addressed some basic questions about the need for the document and the paper's scope.

Q: Why did the AUA Quality Improvement & Patient Safety (QIPS) Committee decide to do a white paper on catheter-associated urinary tract infections (CAUTI)?

The growing importance of CAUTI in the healthcare arena brought the topic to the forefront. The Centers for Medicare & Medicaid Services (CMS) implemented quality measures aimed at reducing the number of these infections. However, most of the attention has been on CAUTI prevention, which although noble, has very little input from urology. We are frequently on the front line in addressing this in our hospitals; therefore, we should also be among those providing guidance on the subject.

Q: Who is the target audience of the white paper and how should it be used?

This white paper is ideally for all healthcare providers but especially those in urology, which is why we assembled a multi-stakeholder panel. The white paper alerts the urologic care provider (and others) on how to best address some of the conditions when urologic patients are involved. However, the document should also serve as an alert for instances when a urologist should be called when a CAUTI is suspected, preventing possible problems from failed attempts to insert or remove a catheter.

Q: One of the foci of the paper is definitions, why is that important?

There are a wide variety of definitions from various organizations, even among healthcare systems and providers, as to what constitutes a CAUTI. Providers, therefore, need to realize what definitions they are using and how this may impact care and treatment. The white paper notes many of the commonly used definitions, but even this list is incomplete. Because these infections cross specialties, it is extremely important that we "speak the same language" when we're treating patients.

Q: Don't most healthcare providers know how to insert and remove a catheter?

In a general sense, they do. However, the high rate of CAUTI indicates that more education is needed; so, we devoted a portion of the white paper to this. Again, our hope is to improve the quality of care provided to patients by preventing difficulties and/or problems.

Q: The white paper calls attention to identifying CAUTI in specialized urologic patients. Why are these infections typically so hard to identify?

It can be difficult to determine baseline parameters for some patients as traditional signs and symptoms are not uniform in patients with certain specific conditions. Our list is not complete, but some of the unique conditions we highlight include patients with delirium, neurogenic bladder patients, and patients with a reconstructed urinary tract.

Read the full White Paper on Catheter-Associated Urinary Tract Infections: Definitions and Significance in the Urologic Patient [pdf].

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