Reducing the risk of catheter-related urinary tract infection.

Primum non nocere (first do no harm) is the ancient Latin phrase that reminds nurses that first principle of healthcare is not to harm those entrusted to our care. Yet, common healthcare interventions, such as urinary catheterization, have the potential to do patients great harm. The patient may even pay with his or her life if a urinary catheter is inserted without clinical indications or if the nurse fails to do his or her utmost to protect the patient from infection. Urinary tract infection (UTI) is the most common of healthcare-related infection. UTI in hospital inpatients normally occurs in people who have a urinary catheter inserted. Urinary catheterization is common and although the risks of catheter-associated UTI are small, the consequences or catheter-associated UTI can be life threatening. Urinary catheterization increases morbidity by a factor of three. Restricting catheterization to those who clinically require this invasive procedure can reduce the number of people who developed infection and life threatening bacteraemia. The use of silver-coated catheters can reduce the risks of infection. Evidence based practice can further reduce risks of catheterization. It is important that informed consent is obtained prior to catheterization. If a person lacks capacity the clinician must act in the person's best interests.