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NCLEX · General

A nurse is preparing to insert a urinary catheter. Which action is MOST important to prevent catheter-associated urinary tract infection (CAUTI)?

Correct answer

Maintain strict sterile technique throughout the insertion procedure and maintain a closed drainage system — CAUTIs are a major preventable healthcare-associated infection; the majority are preventable with proper insertion technique and maintenance

  1. A Use sterile technique only for the first hour
  2. B Maintain strict sterile technique throughout the insertion procedure and maintain a closed drainage system — CAUTIs are a major preventable healthcare-associated infection; the majority are preventable with proper insertion technique and maintenance
  3. C Rinse the catheter with tap water before insertion
  4. D Change the catheter every 24 hours routinely

Why this is the answer

CAUTI PREVENTION BUNDLE: INDICATIONS: Only insert when medically necessary — review daily whether continued catheterisation is needed; INSERTION TECHNIQUE: STERILE: sterile gloves, draping, catheter; cleanse with antiseptic; insert without contamination; CLOSED DRAINAGE: Never disconnect catheter from drainage bag (without specific indication); use a preconnected closed system; DRAINAGE BAG MANAGEMENT: Keep below bladder level at all times; empty regularly (never allow to fill completely); do not place on floor; don't kink or obstruct tubing; CARE AND MAINTENANCE: Daily periurethral cleansing (soap and water); AVOID: Irrigation unless ordered for obstruction; routine catheter changes on schedule (change only when indicated: obstruction, soiled, malfunction); DOCUMENTATION: Date of insertion; indication; daily reassessment of continued need; IMPACT: CAUTIs account for ~30% of all healthcare-associated infections; each CAUTI adds ~$600-700 in hospital costs and increases patient morbidity; many are considered 'never events' when proper protocols are followed.
Source: NCLEX-PN Safe Care — Infection Control, CAUTI Prevention

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