What Is a Catheter-Associated UTI (CAUTI)?
In Australia, approximately 1% of people with urinary catheters develop Catheter-Associated Urinary Tract Infections (CAUTIs). CAUTIs occur when bacteria enters the urinary tract through an indwelling catheter, causing infection. The longer a urinary catheter in place, the higher the risk is for infection due to a biofilm that can form on the catheter. This is one of the most common forms of Healthcare-Associated Infections (HAIs) with 26% of all people in hospital receiving a urinary catheter.
It’s important to understand the risks, warning signs and what to do if a Urinary Tract Infection (UTI) develops, especially if you or the person you care for has received an indwelling urinary catheter. UTIs that are left untreated can create more serious health conditions like sepsis and kidney infections making it essential to take preventative measures.
Common UTI Symptoms Catheter Carers Should Watch For
As a carer, identifying the most common symptoms of a UTI is necessary when your care recipient is using a urology products. The most common symptoms are:
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Pain or stinging when urinating
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Frequent urge to urinate
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Cloudy, foul smelling or blood in urine
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Fever or chills while
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Discomfort in the pelvic area or pressure on the bladder
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Confusion or lethargy, especially in elderly patients
CAUTI Prevention Checklist: Daily and Weekly Best Practices for Carers
Catheter-Associated Urinary Tract Infections (CAUTIs) are preventable with consistent and meticulous care. Use this checklist to guide daily routines and conduct a more comprehensive weekly review to ensure best practices are followed.
Daily Checklist for CAUTI Prevention
These tasks should be completed every day for each patient with a urinary catheter:
Maintain Hygiene & Cleanliness
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Perform perineal hygiene using soap and water or approved wipes.
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Clean catheter area and tubing gently to remove buildup.
Use Infection Control Measures
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Wash hands thoroughly before and after any catheter care.
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Wear gloves and use aseptic technique at all times.
Check System Function
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Ensure catheter tubing is not kinked or twisted.
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Confirm urine is flowing freely into the drainage bag.
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Make sure the drainage bag is below bladder level to prevent backflow.
Monitor for Infection Signs
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Look for fever, pain, cloudy or foul-smelling urine.
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Report any changes or concerns to the clinical team.
Document Care
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Record all catheter care and observations in patient notes.
Weekly Best Practices
In addition to daily care, these tasks should be completed once per week (or more often as needed):
Deep Cleaning Check
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Perform a full assessment of catheter and drainage system cleanliness.
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Replace any components (e.g. leg straps or tubing) as required.
Equipment Audit
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Check for catheter expiry and assess the need for catheter change.
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Inspect drainage bags for wear, cracks, or odor.
Patient/Caregiver Education
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Reinforce education for patients and caregivers on proper catheter care.
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Remind them not to tug, twist or interfere with the catheter system.
Policy Adherence
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Ensure all care follows facility infection control policies.
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Review and update catheter care documentation practices.
Drainage Bag Management
When emptying drainage bags, it’s also important to check that the catheter is securely in place and that the bag is positioned below the level of the bladder in order to prevent backflow.
Ensure the drainage bag maintains an unobstructed flow by making sure the bag doesn’t touch the floor and there are no blockages within the bag.
Encourage Fluids
Encouraging adequate fluid intake is essential for preventing CAUTIs because it helps flush bacteria from the urinary tract, reducing the risk of infection. Increased urine flow also prevents the buildup of sediment or blockage in the catheter, which can contribute to complications. Unless medically contraindicated, promoting hydration supports overall urinary health and is a simple yet effective way to assist in maintaining catheter function and reducing infection risk.
Long-Term CAUTI Prevention Strategies for Better Patient Outcomes
Prevention over the long term requires more than routine catheter maintenance. Carers should integrate strategic practices that protect bladder health, reduce microbial risk and foster better patient outcomes. The strategies described below should complement daily care tasks and work in partnership with clinical teams.
Hydration and Bladder Health
Promoting regular fluid intake (unless medically contraindicated) is a simple yet powerful preventive measure. Adequate hydration helps dilute urine, reduces the concentration of bacteria and fosters more frequent flushing of the urinary tract. This mitigates stagnation, which can otherwise foster bacterial growth along the catheter and within the drainage system.
Reviewing Catheter Necessity Regularly
A catheter should remain in place only as long as it is clinically required. Each day, carers should question whether removal is possible and collaborate with medical staff to discontinue use at the earliest safe opportunity. Evidence shows that the risk of infection increases with prolonged catheter duration, making timely removal one of the most effective protective measures.
Use of Closed Drainage Systems
Maintaining a sterile, closed drainage system is essential. Limiting disconnections or circuit breaks reduces opportunities for bacterial entry. The drainage bag should always stay below bladder level to prevent backflow and tubing should be routed to avoid kinks or obstructions. Securement of the catheter helps minimise movement that could introduce microtrauma or dislodgement.
Intermittent Catheterisation as a Safer Alternative
Where clinically appropriate, intermittent catheterisation may offer a safer option compared to long-term indwelling devices. By inserting and removing a catheter periodically with appropriate aseptic technique, carers reduce the continuous presence of a foreign body— lowering risk of biofilm formation and infection. It’s important to work with healthcare providers to determine whether this approach is suitable for a given patient.
Healthcare Facility Considerations for CAUTI Prevention
Prevention must be systemic, not just individual. Healthcare facilities should ensure:
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Comprehensive staff training in catheter insertion, maintenance and removal with aseptic technique.
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Protocol adherence guided by evidence-based standards, with auditing and feedback loops.
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Reliable access to sterile, high-quality equipment, such as closed drainage systems and securement devices.
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Multidisciplinary collaboration between carers, nurses, infection control and facility leadership to monitor outcomes, update practices and rapidly respond to infection trends.
When carers and facility teams collaborate, care becomes safer, more consistent and more responsive.
Enhancing Comfort and Dignity for Long-Term Catheter Users
Preventing infection is vital, but so is maintaining patient comfort and dignity. Key practices include:
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Applying barrier creams or skin protectants to reduce friction and irritation around the catheter site.
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Using night drainage bags or overnight systems to allow uninterrupted sleep and reduce bag changes.
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Employing discreet securement devices or tubing guides that minimise visibility, tugging, or accidental dislodgement.
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Being vigilant for skin breakdown, pressure injuries, or leakage and addressing any discomfort promptly.
By attending to comfort and dignity, carers help preserve quality of life while maintaining safety.
Conclusion
Preventing CAUTIs is not an optional extra, it’s a core responsibility for carers and healthcare systems alike. Through regular review of catheter necessity, promotion of hydration, use of closed systems, considering intermittent alternatives and collaboration with facility teams, infection risk can be significantly reduced. Coupled with strategies to enhance comfort and dignity, this approach supports safer, more respectful and more effective long-term catheter care.
Sources
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Clinical Excellence Commission, NSW — Catheter associated urinary tract infections (CAUTI) prevention, NSW Health. (CEC Health NSW)
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Australian Commission on Safety and Quality in Health Care / NHMRC — Australian Guidelines for the Prevention and Control of Infection in Healthcare (Safety and Quality Commission)
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SA Health — Catheter‑associated urinary tract infection: prevention and control principles (SA Health)
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EAUN / Australia & New Zealand Urological Nurses Society — EAUN Adult Catheterisation Guidelines (Anzuns)
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NSW Health — Insertion and Management of Urethral Catheters for Adult Patients (Health NSW)
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Australian and New Zealand literature on CAUTI and healthcare‑associated infection burden (IDH Journal)