National Healthcare Safety Network Catheter Associated Urinary Tract Infection (CAUTI)
Standardized Infection Ratio (SIR) of healthcare-associated, catheter-associated urinary tract infections (UTI) will be calculated among patients in bedded inpatient care locations, except level II or level III neonatal intensive care units (NICU). This includes acute care general hospitals, long-term acute care hospitals, rehabilitation hospitals, oncology hospitals, and behavior health hospitals.
ACP does not support NQF measure #0138: “National Healthcare Safety Network Catheter Associated Urinary Tract Infection.” This measure represents an important clinical concept; however, national CAUTI rates are already low and it may be difficult for facilities to score 100% on this measure. Also, while the specifications include appropriate exclusion criteria, criteria should also include patients who screen positive for bacteriuria immediately after catheterization. Furthermore, implementation could drive perverse clinician behavior because reimbursement programs emphasize the importance of CAUTI reduction at the facility level. Finally, while this measure is appropriately specified to assess performance at the level of the facility, we note that it is difficult to extrapolate the measure down to the individual clinician level of analysis.