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S T A M P I N G
O U T
S S I
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Keep it clean and closed
You wouldn't think of starting an IV line without washing your
hands and prepping the skin. Catheterization also demands aseptic technique to ensure a clean insertion. "The perception may be
that if it's not a central line going into the blood, you don't need to
take the same care," says Nasia Safdar, MD, PhD, director of
infection prevention at the University of Wisconsin Hospital in
Madison. "But it's just as critical, if not more so." Considering the
organisms and moisture on the skin in the perineal area, she says,
hand hygiene, gloving and skin prepping are important steps to
take.
Once the catheter is in, proper maintenance is key. The guidelines recommend a closed drainage system with minimal disconnection and minimal manipulation of the catheter, which can
introduce bacteria. The collection bag should always be below the
bladder to prevent backflow.
Coatings considered
The pre-op antibiotics you're administering to your surgical
patients are too narrowly targeted to have any preventive effect
against CAUTI, says Dr. Hooton. So catheters treated with silver
alloy (noted for its antibacterial properties), antibiotics or other
antimicrobial substances would seem to offer a more direct
defense. Clinically speaking, however, the jury's still out.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2012
