10 Exemplars 225
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Wipe Out CAUTI: Implementing Nonbasin Bathing to
Reduce CAUTIs
Abigail C. Strouse, DNP, RN, ACNS-BC, NEA-BC, CBN
Director of clinical services surgery/neuro/ortho
WellSpan Health York Hospital, Department of Nursing
York, Pennsylvania, USA
Practice Question
Despite sustained efforts to implement best practices related to catheter-associated
urinary tract infections (CAUTI) prevention, our hospital continued to see an in-
crease in its CAUTI rate. After clinical review of each CAUTI event, it was apparent
that more CAUTI events were associated with daily catheter care and maintenance
than catheter insertion. Though CDC guidelines suggest that the use of antisep-
tics for catheter insertion is unnecessary, a specific method or cleansing agent for
daily routine hygiene is not defined. Because most CAUTI prevention guidelines
do not address catheter care and hygiene specifically, the best methods for bath-
ing or cleansing adult catheterized patients to help prevent CAUTIs is unknown.
As a result, a multidisciplinary CAUTI prevention workgroup began investigating
innovative practices that focused on improving the daily care and maintenance of
indwelling catheters, and quickly a study question arose: Do current bathing prac-
tices impact the transmission of healthcare–associated infections (HAIs) and CAU-
TIs among hospitalized adult patients? More specifically, could the use of plain
disposable bathing wipes, instead of traditional basin bathing, reduce the incidence
of CAUTIs for adult patients on a medical surgical nursing unit?
Evidence
The team performed a search of literature for articles published between 2000
and 2014 utilizing the CINAHL, Cochrane, OVID, PubMed, Virginia Henderson
