A new survey study in JAMA Network Open shows that U.S. hospitals have substantially expanded their use of three key practices to prevent catheter-associated urinary tract infections (CAUTIs) over the past two decades. The study, led by Sanjay Saint of Northwell Health, analyzed six waves of surveys from 2005 to 2025 involving 1,461 hospitals, including 133 VA hospitals and 1,328 nonfederal hospitals.
Among both VA and nonfederal hospitals, use of portable bladder ultrasound scanners and urinary catheter reminders or stop orders increased significantly. Nurse-initiated urinary catheter discontinuation also rose, but remained below 60% in both groups by 2025. The authors say these practices help reduce catheter duration, the most modifiable risk factor for catheter-related harm.
Nearly all hospitals reported having CAUTI surveillance systems by 2025, and most monitored catheter duration and discontinuation. However, use of silver alloy Foley catheters was low and declined among nonfederal hospitals, which the researchers say likely reflects limited evidence and guidelines that do not recommend routine use. The study's limitations include possible nonresponse bias due to survey response rates.