Urinary tract infections (UTI) and catheter-associated urinary tract infections (CAUTI) are reported as a leading cause of E. coli and Gram-negative bloodstream infections. This section outlines the recommended actions to take to reduce infections linked to this source.

Action: implement prevention guidelines

Implement the National Institute for Health and Care Excellence (NICE) and Public Health England (PHE) guidelines for the prevention, diagnosis and management of UTIs.

• UTI diagnosis in people over 65
• Antimicrobial newsletter – Antimicrobial newsletter example (provided by NHS Northamptonshire ICS).

Action: review compliance

Review compliance with best practice across the health care economy.

• Best practice guide – This best practice guide (2018/19) has been developed as a tool for commissioners, continence leads and those involved with the care pathway for patients with continence problems (provided by the unplanned admissions committee).

Action: plan for UTI CQUIN

Ensure that acute providers have plans to achieve the UTI commissioning for quality and innovation (CQUIN).

• The impact of the SIGN UTI 2012 guidelines on UTI antibiotic use in secondary care – The impact of the SIGN UTI 2012 guidelines on UTI antibiotic use in secondary care (provided by Royal Cornwall Hospital Trust).

Action: provide diagnosis support

Ensure that in primary care all providers are supported in the accurate diagnosis of UTIs by putting in place support for effective systems.

• Taking a urine example – Guidance on how to take a urine sample (provided by Norfolk and Waveney ICS).
• Suspected UTI patient questionnaire – Suspected UTI patient questionnaire (provided by Norfolk and Waveney ICS).
  Primary care triage UTI form – Primary care triage UTI form for patients presenting with UTI symptoms (provided by Norfolk and Waveney ICS).
• Taking a mid-stream urine sample  – Taking a mid-stream urine sample guidance (provided by Norfolk and Waveney ICS).

Action: review management

Review management of recurrent UTI.

• NICE – UTI (recurrent) – NICE guidance on UTI (recurrent): antimicrobial prescribing

Action: establish provider point prevalence for UTIs

Use the NICE definitions to establish provider point prevalence for UTI and measure continuous improvement.

• Urinary tract infection – All NICE products on UTI. Includes guidance, advice, NICE Pathways and quality standards.

Action: review services

Review services commissioned for managing incontinence and check against best practice.

• Service specification for continence – Service specification for continence (provided by Buckinghamshire, Oxfordshire and Berkshire West ICS).

Action: review catheter training and audit

Ensure aseptic non touch technique (ANTT) training and audit is in place for all provider organisations, including primary care where catheter work is undertaken.

• Routine catheter pathway – Routine catheter pathway (provided by Kent Community Health Foundation Trust).

Action: implement a system wide approach

Implement a system wide approach to catheter assessment and management.

• Urinary catheter passport  – Our catheter passport and associated resources.
• Catheter audit tool – Catheter audit tool (provided by Frimley Health NHS Foundation Trust).
• Catheter Decision Tree – Catheter assessment — decision making tree (provided by Buckinghamshire, Oxfordshire and Berkshire West ICS).

Action: work to best practice standards

Review catheter management practises against best practice, in hours and out of hours response to blocked and bypassing catheters.

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