Using NHSN Definitions
for Surveillance: Urinary
Tract Infection (UTI)
STANLEY OSTRAWSKI, MS, RN, MT(ASCP), CIC
Infection Preventionist Consultant
Objectives
• Explain how to calculate a CAUTI rate
• Explain how to complete NHSN UTI forms using CDC
definitions and protocols
• Apply case definitions of Urinary Catheterassociated infections to case studies
Introduction – Urinary Tract
Infections and Indwelling
Urinary Catheters
• The urinary tract is the most
common site of HAI
• Almost all UTIs are directly
related to catheterization of
the urinary tract
• CAUTI can lead to
complications such as
pyelonephritis or bacteremia,
CAUTI –Terms and
Definitions

Use CDC Definitions for the following:
–
–
–
–
–
CAUTI
Indwelling catheter
SUTI
ABUTI
OUTI
Definition: CAUTI
CAUTI is a urinary tract infection
(UTI) that occurs in a patient
who had an indwelling urinary
catheter in place within the 48hour period before the onset of
the UTI
Definition: Indwelling
Catheter
• A drainage tube that is
inserted into the urinary
bladder through the urethra,
is left in place, and is
connected to a closed
collection system.
– Also called a Foley catheter
– Does not include straight in and
out catheters
– Does not include suprapubic or
nephrostomy catheters
Rm
#
Name
Ag Diagnosis
Catheter IV
e
PICU - Monday, October 31, 2011 1:00 PM
106
Brandon Smith
6
Influenza
PICC
107
Nicole Brown
Aamina Bidouk
Pneumonia
Otitis Media
Status epilepticus
CVC – Femoral
108
18
mos.
3
109
Robin White
6
110
David Cranshaw
10
111
Susanna Solomon
112
Davey Blue
113
Amy O’Donnell –
transferred to Surgical 6
Peds Ward at 11AM
IPPB q 6 hr
Tracheostomy,
ventilator
Viral meningitis
Swan ganz
PICC
PIV X 2
7 mos
Asthmatic
bronchitis
RSV pneumonia
PIV right antecub
CVC Jugular
PIV right antecub
Ventilator –
weaning off
IPPB q 6 hr
4
Pneumonia
CVC – Subclavian
Vent cont.
PICC
Vent . Extubated
at 10:30 am – on
room air
Swan ganz
CVC subclavian
PICC
Vent cont.
114
Brie Bennett
2
115
Harrison Black –
admitted from ED @
9 am
14
mos
Foley to dd
Resp
Cath for
spec.
Foley out @
10:30AM
Repair –
congenital heart
defect
Anaphalaxis to bee Foley to dd
sting
RSV
pneumonia/congen
ital heart disease
Intubated in ED–
on vent cont.
Specimen Collection
Urine specimens for culture should be
processed as soon as possible, preferably
within 1 to 2 hours. If urine specimens
cannot be processed within 30 minutes of
collection, they should be refrigerated, or
inoculated into primary isolation medium
before transport, or transported in an
appropriate urine preservative.
Refrigerated specimens should be
cultured within 24 hours.
Calculating the CAUTI
Rate
*Stratify by location type –
•ICU or other location
2009 NHSN Report
Edwards JR, et al. Am J Infect Control 2009;37:783-805
2011 NHSN Report
Add Event
Turning Data into
Knowledge
Have a plan to share the data with those
individuals who can make a difference:
•Nursing Staff
•Medical staff
•Administration
•Board of Directors
•Performance Improvement department
•Patient safety leaders