{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:18:09Z","timestamp":1778653089734,"version":"3.51.4"},"reference-count":11,"publisher":"AACN Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"\n Background<\/jats:title>\n Catheter-associated urinary tract infections are among the most prevalent and costly types of hospital-acquired infections. During the COVID-19 pandemic, growing numbers of critical care patients required indwelling urinary catheters, leading to higher infection rates.<\/jats:p>\n <\/jats:sec>\n \n Local Problem<\/jats:title>\n A critical care unit saw a 7-fold increase in the rate of catheter-associated urinary tract infection during the COVID-19 pandemic. A review of procedures showed that the current standard of care for preventing such infections was inadequate. In particular, patients who could not have indwelling urinary catheters promptly removed risked a potential false-positive diagnosis of catheter-associated urinary tract infection due to clinicians\u2019 use of long-term catheters to obtain urine specimens for microbiological evaluation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A literature review was performed to gather evidence on best practices for urine specimen collection in the critical care unit. An interprofessional task force including frontline nurses advocated implementation of a pilot project in 2 critical care units involving exchange of catheters before obtaining urine specimens for microbiological evaluation in any patient who had an indwelling catheter in place for more than 24 hours.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Implementation of the new protocol resulted in a major reduction in the diagnosis of catheter-associated urinary tract infection, with no incidents occurring for 2 consecutive quarters. Based on these results, the new evidence-based workflow was incorporated as the standard of care for all adult inpatients.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Catheter exchange before collection of urine specimens in patients requiring urine culture evaluation can improve accuracy of diagnosis of catheter-associated urinary tract infection and promote antibiotic stewardship.<\/jats:p>\n <\/jats:sec>","DOI":"10.4037\/ccn2025857","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T20:32:54Z","timestamp":1743712374000},"page":"25-32","source":"Crossref","is-referenced-by-count":4,"title":["Diagnostic Precision: Exchanging Urinary Catheters Before Urine Specimen Collection to Reduce Catheter-Associated Urinary Tract Infection"],"prefix":"10.4037","volume":"45","author":[{"given":"Kathleen","family":"Romano","sequence":"first","affiliation":[{"name":"Kathleen Romano is a nurse leader in the step-down unit, Memorial Sloan Kettering Cancer Center, New York, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Leone","sequence":"additional","affiliation":[{"name":"Jessica Leone is an advanced practice provider, Memorial Sloan Kettering Cancer Center."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora","family":"Love","sequence":"additional","affiliation":[{"name":"Nora Love is a clinical nurse specialist, Memorial Sloan Kettering Cancer Center."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Caramore","sequence":"additional","affiliation":[{"name":"Amy Caramore is a nurse leader of endoscopy, gastroenterology, hepatology, and nutrition services, Memorial Sloan Kettering Cancer Center."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2471","reference":[{"key":"2025040110331713200_b1-0450025","unstructured":"National Healthcare Safety Network\n . Urinary tract infection (catheter-associated urinary tract infection [CAUTI] and non-catheter-associated urinary tract infection) events. 2022. Accessed January 8, 2025. https:\/\/www.cdc.gov\/nhsn\/psc\/uti\/index.html"},{"issue":"6","key":"2025040110331713200_b2-0450025","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.ajic.2020.11.016","article-title":"Implementation of evidence-based strategies to reduce catheter-associated urinary tract infections among hospitalized, post-surgical adults","volume":"49","author":"Gauron","year":"2021","journal-title":"Am J Infect Control"},{"key":"2025040110331713200_b3-0450025","unstructured":"Agency for Healthcare Research and Quality\n . Toolkit for reducing catheter-associated urinary tract infections in hospital units: implementation guide. October\u20082015. Accessed November 12, 2023. https:\/\/www.ahrq.gov\/hai\/cauti-tools\/impl-guide\/index.html"},{"key":"2025040110331713200_b4-0450025","unstructured":"Centers for Disease Control and Prevention\n . Patients with indwelling urinary catheters: overview. May\u20089, 2019. Accessed February 19, 2022. https:\/\/www.cdc.gov\/hai\/prevent\/cauti\/indwelling\/overview.html"},{"issue":"10","key":"2025040110331713200_b5-0450025","doi-asserted-by":"publisher","first-page":"1582","DOI":"10.1017\/ice.2023.30","article-title":"Using clinical decision support to improve urine testing and antibiotic utilization","volume":"44","author":"Yarrington","year":"2023","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"6","key":"2025040110331713200_b6-0450025","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3238\/arztebl.2020.0083","article-title":"Catheter-associated urinary tract infections in adult patients","volume":"117","author":"Kranz","year":"2020","journal-title":"Dtsch Arztebl Int"},{"issue":"4","key":"2025040110331713200_b7-0450025","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1111\/lam.13144","article-title":"Bacterial biofilm formation on indwelling urethral catheters","volume":"68","author":"Pelling","year":"2019","journal-title":"Lett Appl Microbiol"},{"issue":"10","key":"2025040110331713200_b8-0450025","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1093\/cid\/ciz021","article-title":"Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America","volume":"68","author":"Nicolle","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"5","key":"2025040110331713200_b9-0450025","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1086\/650482","article-title":"Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America","volume":"50","author":"Hooton","year":"2010","journal-title":"Clin Infect Dis"},{"issue":"9","key":"2025040110331713200_b10-0450025","doi-asserted-by":"publisher","first-page":"e2690","DOI":"10.1093\/cid\/ciaa1152","article-title":"Protocolized urine sampling is associated with reduced catheter-associated urinary tract infections: a pre- and postintervention study","volume":"73","author":"Frontera","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"1","key":"2025040110331713200_b11-0450025","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.idh.2016.12.003","article-title":"A pilot study on improving the appropriateness of urine specimen collection among catheterised patients in acute aged care","volume":"22","author":"Gralton","year":"2017","journal-title":"Infect Dis Health"}],"container-title":["Critical Care Nurse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/45\/2\/25\/162465\/25.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/45\/2\/25\/162465\/25.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T20:32:56Z","timestamp":1743712376000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article\/45\/2\/25\/32718\/Diagnostic-Precision-Exchanging-Urinary-Catheters"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ccn2025857","relation":{},"ISSN":["0279-5442","1940-8250"],"issn-type":[{"value":"0279-5442","type":"print"},{"value":"1940-8250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,1]]}}}