How to Prevent Catheter Associated UTIs (CAUTIs)
A urinary tract infection (UTI) is an infection that occurs within a part of the urinary system such as the kidneys, bladder, ureters, or urethra. Catheter users have an increased chance of developing urinary tract infections due to the increased possibility of bacteria entering the urethra through catheter insertion.
The threat of a UTI is most prominent in individuals using indwelling catheters due to the prolonged period of time that these specific catheters are inside the bladder. However, if proper precautions are not used when inserting intermittent catheters or when applying external catheters, urinary tract infections can also occur.
What Causes Catheter-Associated Urinary Tract Infections?
Typically, the urethra is considered a decently sterile environment, but bacteria can be introduced if given the opportunity. This opportunity for infection can arise in a few different ways, so it’s important to always follow proper hygienic practices before using your catheter. If you haven’t properly cleansed your hands before insertion, bacteria can be transferred from your hands to the insertion point or to the catheter itself, which can lead to an infection.
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Additionally, if the insertion site isn’t properly cleansed, bacteria around the insertion site can be pushed into the urethra upon insertion. Your catheter can also collect bacteria if it is not placed on a sterile surface prior to usage. Most catheter kits will include gloves to protect the hands, a sanitary pad to protect the catheter, and BZK/iodine wipes to remove insertion area bacteria. It is important to utilize these additional tools to protect your body from bacteria. Once bacteria is in the urethra, the bacteria can start to multiply and cause the symptoms you’d typically associate with a urinary tract infection (UTI).
Urinary Tract Infection (UTI) Symptoms
- Burning sensation or pain with urination
- Frequent, urgent needs to urinate
- Cloudy, foul-smelling, or bloody urine
- Fever or chills
- Lower abdominal pain or pelvic pressure
Self-Catheterization and CAUTIs
While intermittent self-catheterization is considered a safe procedure for emptying the bladder, some catheter styles carry a higher risk for UTIs depending on the individual user. It's important to find the style of catheter that works best for you.
Hydrophilic catheters are a great option for those that have recurring CAUTIs. Hydrophilic catheters have hydrophilic coating on the outside that is activated when the sterile water/saline packet is burst inside the catheter packaging. Hydrophilic catheters differ from other types of catheters because other catheters use a standard lubricating jelly on top of the catheter, as opposed to a hydrophilic coating. With the standard lubricating jelly, a catheter is not as slippery as it would be with a hydrophilic coating, which can result in a more difficult insertion.
Closed System catheters are preferred for individuals with chronic CAUTIs because they further limit the exposure of the catheter to contamination. These catheters are contained within a urine collection bag, so the catheter is going directly from a sterile environment to the urethra, with only the tip of the catheter being briefly exposed before insertion. Many closed system catheters also offer an Introducer Tip, which protects the end of the catheter from exposure, as well. These catheters are offered in both lubricated and hydrophilic varieties.
Four Tips to Avoid a Catheter-Associated Urinary Tract Infection (CAUTI)
1. Keep Clean
Although your hands may look clean, they’re usually the means through which bacteria is being transferred to your catheter and into your urethra. Always wash your hands with soap and water before you use your catheter. It’s also a good idea to shower at minimum once daily to ensure your skin stays clean throughout the day.
It can be a good idea to actually open the catheter prior to handwashing, as the outer package of the catheter is not sterile if it has been stored in a pocket, bag, or purse. Gloves, if available, can be a great second line of defense for patients catheterizing in public restrooms, and are often included in catheter insertion kits. Additionally, Medicaid plans and some private insurances will cover gloves independently if signed for by a doctor as part of a catheterization regimen.
2. Catheter Insertion Kits
The right catheter supplies can ensure easy, sterile catheterization. A catheter insertion kit can further reduce the risk of a UTI by providing gloves, sterilizing wipes, and lubricant in each kit. Gloves protect against bacteria on your hands, sterilizing wipes cleanse the area prior to insertion, sterile lubricant allows for easy insertion, and a sterile drape covers surfaces to avoid contamination of the catheter supplies.
Some catheters will also have an adhesive dot on the side of the catheter packaging, enabling individuals to stick the outer packaging of the catheter to any surface while preserving the sanitation of the catheter itself. This feature allows users with limited dexterity to open the catheter with one hand. If the catheter includes a grip, this should be utilized, so as not to touch the catheter tube itself, which can lead to bacterial contamination.
3. Hydration & Regular Voiding
If you want to avoid putting excessive pressure on your bladder then you’ll also want to ensure you’re not constipated. Constipation can interfere with your bladder’s ability to empty fully by applying pressure from the rectum. If you do feel like you could benefit from being more regular then increase your intake of fiber, fluids, and probiotic-rich foods like yogurt and sauerkraut.
4. Focus on Fiber
If you want to avoid putting excessive pressure on your bladder, you will also want to ensure you are actively preventing constipation. Constipation, or a full bowel, can interfere with your bladder’s ability to empty fully by applying pressure from the rectum. Increasing your intake of fiber, fluids, and probiotic-rich foods are all great ways to prevent constipation from occurring.
Catheters Through Insurance
One of the primary challenges of catheter use is practicing proper sanitation to minimize the risks of infection, rashes, and other uncomfortable or dangerous complications.The first line of defense in preventing catheter complications is using a sterile catheter each time you catheterize. Medicare allows for up to 200 intermittent catheters per month. With 200 catheters per month, this allows for 6 catheterizations per day with additional catheters leftover for any unexpected needs. When you use a new catheter each time, you ensure the catheter is clean and sterile. Sterile catheters dramatically decrease urinary tract infections (UTIs) and can therefore prevent CAUTIs from occurring.
If you would like to receive 200 catheters per month at no cost through your insurance, check your eligibility through Aeroflow Urology. Our Continence Care Specialists will take care of all of the paperwork, from your healthcare provider to your insurance provider. All you have to do is fill out our quick and easy 2-step form, and we’ll take care of the rest.
Mica Phillips
Mica has been at Aeroflow for over six years. He brings creativity to a sometimes stagnant and complacent industry and tries his best to uncomplicate the complex world of Insurance. He is a graduate of the University of North Carolina and holds a Bachelor’s degree in English. In addition to his daily responsibilities as Vice President of Aeroflow Urology, he’s contributed to numerous articles for online journals regarding senior care, incontinence, and navigating insurance benefits. In his spare time, he enjoys listening to live music, visiting breweries, and traveling the world with his wife.
Information provided on the Aeroflow Urology website is not intended as a substitute to medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.