Urinary Tract Infection (UTI)

The NHS Safety Thermometer asks you to record information about any urinary tract infection (UTI) treatment and urinary catheterisation. In the ‘UTI treat’ column, record whether or not the patient is being treated for a UTI. Treatment for a UTI is based on notes, clinical judgment and patient feedback.

 

If the patient is being treated for a UTI, the Safety Thermometer asks you to record whether the treatment started before the patient came was admitted to your organisation (old) or after the patient was admitted to your organisation (new).

 

If treatment for or diagnosis of the UTI started before the patient was admitted to your organisation, select ‘Old UTI’ from the drop down menu in the ‘UTI Old/ New’ column. If the treatment for the UTI started whilst the patient was under your care, select ‘New UTI’ in the ‘UTI Old/New’ column. Otherwise, if the patient is not being treated for or diagnosed with a UTI, select ‘No UTI’.

 

The NHS Safety Thermometer also asks you to record any information about an indwelling urethral urinary catheter. This EXCLUDES supra-pubic catheters and other stents. If the patient has, or has had, an indwelling urethral urinary catheter at any point in the last 72 hours, record the number of days that it has been in place. There are four options for recording this information available on the drop down menu on the survey form; ‘1-28 days’, ‘28+ days’, ‘days unknown’ and ‘no catheter’. If the patient does not have an indwelling urethral urinary catheter and has not had one at any point in the last 72 hours, record ‘No catheter’.

 

This data enables the calculation of the following indicators:

  • C1:
    • The proportion of patients with an indwelling urethral urinary catheter present on the day of survey or removed in the last 72 hours.
  • C2:
    • The proportion of patients with an indwelling urethral urinary catheter also receiving treatment for ANY urinary tract infection (on the basis of notes, clinical judgement and patient feedback).
  • C3:
    • The proportion of patients with an indwelling urethral urinary catheter also receiving treatment for a NEW urinary tract infection (on the basis of notes, clinical judgement and patient feedback) C2 and C3 can also be viewed by OLD UTI. The proportion of patients (without catheters) being treated for a UTI can also viewed.

 

Your Queries:

If the patient has a catheter AND a UTI BUT the two are not connected, does this need to be logged as a harm?

​​​The definition is that if the patient has both a UTI AND and catheter or any duration is is therefore a CAUTI and thus a harm.  This has been a bone of much contention but was the most practical approach to take as the only way you can generally define whether a UTI is actually related to a catheter is through microbiology which is not much use in a point prevalence survey!

Do you include patients with an infection after 10 days or is it only those that an infection presents before 10 days?

We include both types patients. The measure is from when treatment starts, not the length of the infection. For example a person entering the ward already being treated would be labelled as OLD, after that it would be labelled NEW regardless of whether treatment lasted for 2 days or 20.