Reducing Gram-negative bloodstream infections — urinary tract infections

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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 PNG, 268.4 KB

UTI diagnosis in those older than 65 years (provided by Nene CCG).

Antimicrobial newsletter DOCX, 124.3 KB

Antimicrobial newsletter example (provided by Nene CCG).


Action: review compliance

Review compliance with best practice across the health care economy.


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 DOCX, 38.3 KB

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 sample PDF, 654.8 KB

Guidance on how to take a urine sample (provided by NHS Norfolk and Waveney CCG).

Suspected UTI patient questionnaire PDF, 244.8 KB

Suspected UTI patient questionnaire (provided by NHS Norfolk and Waveney CCG).

Primary care triage UTI form PDF, 199.2 KB

Primary care triage UTI form for patients presenting with UTI symptoms (provided by NHS Norfolk and Waveney CCG).

Taking a mid-stream urine sample PDF, 401.2 KB

Taking a mid-stream urine sample guidance (provided by NHS Norfolk and Waveney CCG).


Action: review management

Review management of recurrent UTI.


Action: establish provider point prevalence for UTIs

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


Action: review services

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

Service specification for continence DOCX, 53.8 KB

Service specification for continence (provided by East Berkshire CCG).


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 PNG, 145.1 KB

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.

Catheter audit tool DOCX, 58.5 KB

Catheter audit tool (provided by Frimley Health NHS Foundation Trust).

Catheter decision tree PPTX, 87.4 KB

Catheter assessment — decision making tree (provided by East Berkshire CCG).


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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