3. What are the best practices for preventing CAUTI
associated with obstructed urinary catheters?
Evidence addressing the key questions was used to formulate
recommendations, and explicit links between the evidence
and recommendations are available in the Evidence
Review in the body of the guideline and Evidence Tables and
GRADE Tables in the Appendices. It is important to note
that Category I recommendations are all considered strong
recommendations and should be equally implemented; it is
only the quality of the evidence underlying the recommendation
that distinguishes between levels A and B. Category
IC recommendations are required by state or federal regulation
and may have any level of supporting evidence. The
categorization scheme used in this guideline is presented in
Table 1 in the Summary of Recommendations and described
further in the Methods section.
The Summary of Recommendations is organized as follows:
(1) recommendations for who should receive indwelling
urinary catheters (or, for certain populations, alternatives to
indwelling catheters); (2) recommendations for catheter insertion;
(3) recommendations for catheter maintenance; (4)
quality improvement programs to achieve appropriate placement,
care, and removal of catheters; (5) administrative infrastructure
required; and (6) surveillance strategies.
The Implementation and Audit section includes a prioritization
of recommendations (ie, high-priority recommendations
that are essential for every healthcare facility), organized
by modules, in order to provide facilities more
guidance on implementation of these guidelines. A list of
recommended performance measures that can potentially be
used for internal reporting purposes is also included.
Areas in need of further research identified during the
evidence review are outlined in the Recommendations for
Further Research. This section includes guidance for specific
methodological approaches that should be used in future
studies.
Readers who wish to examine the primary evidence underlying
the recommendations are referred to the Evidence
Review in the body of the guideline, and the Evidence Tables
and GRADE Tables in the Appendices. The Evidence Review
includes narrative summaries of the data presented in the
Evidence Tables and GRADE Tables. The Evidence Tables
include all study-level data used in the guideline, and the
GRADE Tables assess the overall quality of evidence for each
question. The Appendices also contain a clearly delineated
search strategy that will be used for periodic updates to ensure
that the guideline remains a timely resource as new information
becomes available.