Best Evidence for Preventing Urinary Tract Infections and Optimizing Care in Adults with Indwelling Urinary Catheters.

BACKGROUND

Catheter-associated urinary tract infection (CAUTI) is the most frequent hospital-acquired infection and remains a major challenge for nursing quality and infection control. Existing studies are fragmented, and high-quality evidence syntheses are lacking.

OBJECTIVE

This study aimed to systematically search for relevant evidence on the prevention and care of catheter-associated urinary tract infections. The evidence was evaluated and integrated to provide reference for clinical practice.

DESIGN

This study was conducted as a systematic evidence summary, following a systematic review methodology to identify, appraise, and synthesize best available evidence on the prevention and care of catheter-associated urinary tract infections.

METHODS

Identify the evidence-based questions, based on the "6S" evidence pyramid model, evidence related to the prevention and care of urinary tract infections in patients with indwelling urinary catheters were systematically searched from relevant databases and relevant websites for clinical decisions, guidelines, evidence summaries, systematic reviews and expert consensuses. The study was initiated in December 2024, and the search period covered from database inception to January 2025. Three researchers who had completed their professional training and assessment at the Evidence-based Nursing Center conducted literature screening, quality evaluation, and evidence synthesis. The study population was global, not restricted to a specific region.

RESULTS

Fourteen studies were included: two clinical decision-making articles, eight guideline articles, two systematic review articles and two expert consensus articles. A total of 32 pieces of evidence were formed in five aspects: pre-catheterization criteria, catheterization techniques and requirements, daily care and maintenance of urinary catheters, catheter removal, and diagnosis and treatment of CAUTI.

CONCLUSION

This study summarizes the best available evidence on the prevention and care of urinary tract infections in patients with indwelling urinary catheters. The findings provide an evidence base for clinical nursing practice, enhance nurses' awareness of CAUTI prevention and care, and support the development of evidence-informed protocols for clinical settings.

TRIAL REGISTRATION: This study was registered at the Center for Evidence-Based Nursing of Fudan University (registration number ES20257362).