Problem Statement

Each year, more than 500,000 cases of Cathether-associated urinary tract infections (CAUTIs) occur in the United States alone despite the policy enacted by Centers for Medicare and Medicaid Services (CMS) to penalize hospitals for incurring hospital acquired infections such as CAUTI(citation). Catheter-associated urinary tract infections, which involve infection of any organs or structures of the urinary tract, have been associated with increased morbidity, mortality, healthcare costs and length of stay (CDC, n.d.). As the single largest source of bacteremia in hospitalized patients, CAUTIs account for 30% to 40% of all hospital-acquired infections. Prolonged catheterization is the principal risk factor for CAUTI (Halm & O’Connor, 2014)

According to the 2009 Guideline for Prevention of CAUTI developed by the Healthcare Infection Control Practices Advisory Committee (HICPAC), one guideline involves minimizing catheter use and limiting duration in all patients especially those at higher risk like the elderly patients (citation). Elderly patients are particularly at risk for developing CAUTI because of additional factors, such as advanced age, abnormalities in urinary function, pre-existing chronic diseases, and weakened immune system, as well as reports of inappropriate utilization of indwelling urinary catheters in this population (Vincitorio et al., 2014).

The Centers for Disease Control and Prevention (CDC) presented several different systems interventions to reduce the risk of CAUTIs (2009). One of these prevention practices is a nurse-directed catheter removal (CDC, 2009). Studies have shown that implementation of nurse-driven protocol in hospitals demonstrated reduction in CAUTI rates (need several citations). As CAUTIs present a considerable problem for hospitalized elderly patients, additional information is required to determine the effectiveness of nurse-driven catheter removal protocol in this patient population.