A Multimodal Approach in Catheter-Associated Urinary Tract Infection (CAUTI) Prevention: A Narrative Review

Abstract. Catheter-associated urinary tract infections (CAUTIs) are a common healthcare problem globally, increasing patient morbidity and deaths, higher costs, and longer hospital stays. Despite prevention guidelines, CAUTI rates remain high due to factors such as prolonged catheter use, bacterial biofilms, and low adherence to prevention measures. The aim of this review is to study existing evidence on the efficacy of a multimodal approach to prevent CAUTI and to evaluate its core components and their effect on infection rates and patient outcomes. A comprehensive review of the peer-reviewed literature, clinical practice guidelines, and position papers from authoritative bodies were explored. The evidence clearly indicates that no single intervention is sufficient to achieve sustained CAUTI reduction. The use of multimodal strategies combining three or more interventions such as catheter use limitation, aseptic insertion techniques, catheter maintenance bundles, staff and patient education, electronic surveillance, audit and feedback has been demonstrated as highly effective strategies. The key interventions include nurse-driven removal protocols, electronic health record (EHR) reminders, two-person catheter insertion techniques, and catheter securement devices. Studies report 60%-83% reduction in CAUTIs with multimodal implementation. Evidence supports multimodal approach as the gold standard for CAUTI prevention. Combination of limited catheter use, aseptic technique, education, and monitoring with feedback can result in significant and sustained reductions in CAUTI rates in healthcare facilities. The strategy calls for a cross-discipline and systems commitment to change the way infections are prevented and to improve patient safety. Keywords: Catheter-Associated Urinary Tract Infection (CAUTI); healthcare-associated infection; multimodal approach; prevention infection control; urinary catheter