How to Prevent Catheter-Associated Urinary Tract Infections (CAUTIs) at Home

Catheter-associated urinary tract infections (CAUTIs) are one of the most common—and most preventable—complications of catheter care. Let’s dive into what it is, signs to watch out for, and how to prevent one from developing at home.

What is a CAUTI?

A catheter-associated urinary tract infection (CAUTI) is an infection of the urinary tract associated with the use of a catheter. It is most commonly caused by Escherichia coli (E. coli) and occurs when bacteria bypass the body's natural defenses through the catheter and multiply in the bladder, leading to an infection. These infections represent a significant healthcare challenge in the United States, where they account for roughly 1 million annual cases and contribute to as much as 80% of all complicated UTIs.

The presence of an indwelling urinary catheter (a type of catheter left in place for extended periods of time) provides a continuous entry point for bacteria. Research has shown that the daily probability of contracting a CAUTI ranges from 3% to 7%, with the risk increasing by 0.3% for each day the catheter remains in place.

To help reduce these risks:

• Prioritize intermittent catheterization over indwelling options when possible, as indwelling catheters carry a higher risk for infection.
• Coordinate with your care team to have indwelling catheters replaced every 30 days.
• Once the indwelling catheter is no longer medically required, coordinate with your care team to have it removed as soon as possible to minimize its duration of use.

Signs of a CAUTI

A CAUTI is not always obvious right away, which is part of what makes it dangerous. If a CAUTI goes untreated, it can develop into more serious complications, such as kidney infections or sepsis (widespread infection of the body). Knowing what to watch for and acting on it early can prevent a manageable infection from becoming a serious one.

Common signs of a CAUTI include:

• Fever above 100.4°F
• Burning or discomfort around the catheter
• Increased pressure, urgency, or frequency
• Lower back or flank pain
• Reduced output
• Chills or rigors
• Changes in urine appearance, odor, or color

If your loved one can’t tell you how they feel or is cognitively impaired (confused, dementia, etc.), a CAUTI may present differently. Watch for:

• New or more confusion or agitation
• Big unexplained changes in behavior or mood
• Increased restlessness or irritability
• Fever without an obvious cause
• Urine leaking around the catheter
• A noticeable decline in alertness or responsiveness

Any of these signs warrants a call to your care team. Do not wait to see if symptoms resolve on their own, as CAUTIs that go untreated can progress quickly, particularly in older adults.

How to Prevent CAUTIs at Home

1. Always start with hand hygiene

Wash your hands thoroughly with soap and water for at least 20 seconds before and after any contact with the catheter or drainage system. This is the single most effective step in preventing infection and should never be skipped, regardless of how routine or “quick” the task feels. An alcohol-based hand sanitizer with at least 60% alcohol is an acceptable substitute in most cases, but it is not a replacement for soap and water when hands are visibly soiled.

2. Keep the collection bag below bladder level and off the floor

When the collection bag is positioned above the bladder, urine can flow backward into the bladder, carrying bacteria with it. Let gravity do its work by keeping the collection bag below the level of the bladder without allowing it to touch the floor. It’s a simple rule that’s easy to forget when repositioning your loved one, moving around the house, or getting in and out of a vehicle. 

3. Clean the insertion site daily

The area where the catheter enters the body (the meatus) should be cleaned once daily with mild soap and water during bathing. That's it. Avoid any powders, creams, or antiseptic sprays unless your care team has specifically recommended them, as these products can irritate the skin and disrupt its natural protective barrier.

4. Don’t disconnect the collection bag unnecessarily

The catheter and collection bag are designed to function as a closed system, and keeping them connected is one of the easiest ways to keep bacteria out. The only routine reason to disconnect them is when switching between a leg bag and a bedside bag—and you should always wash your hands before and after making the switch. 

5. Empty the collection bag before it gets too full

An overfull bag can create back pressure that pushes urine back toward the bladder. A good rule of thumb is to empty the collection bag when it is roughly two-thirds full, or as directed by your care team. Use the spigot at the bottom of the bag to drain it, but avoid letting it touch any surface during emptying. 

6. Secure the catheter to prevent unnecessary movement

The catheter tubing should be secured to the inner thigh using a catheter strap or securement device. Movement at the insertion site causes friction and microtrauma to the surrounding delicate tissue, both of which increase the risk of infection. Check the securement regularly and reposition as needed.

7. Encourage adequate hydration

Unless your care team has restricted fluids, consistent hydration is one of the simplest ways to defend against infection. Adequate fluid intake dilutes urine, flushes the bladder regularly, and makes it harder for bacteria to take hold. Dark, concentrated urine is a sign that the bladder isn't getting flushed often enough, making it a more hospitable environment for infection.

What You Should NOT Do

Some of the most common CAUTI risks at home come from well-intentioned actions that inadvertently introduce bacteria to the bladder. 

Avoid the following:

• Don't clamp the catheter unless specifically instructed
• Don’t place the collection bag above the bladder or on the floor
• Don't irrigate or flush the catheter on your own
• Don't use the drainage port to collect urine samples
• Don’t apply powders, creams, or antiseptic sprays near the insertion site
• Don't delay calling the care team when something looks or smells wrong

Getting the Support You Need at Home

Managing catheter care at home is a learned skill, and like any skill, it gets easier with the right knowledge and support. The best practices outlined above go a long way toward keeping your loved one safe and infection-free. It is also perfectly understandable if managing certain aspects of catheter care independently feels overwhelming.

If you’d like help managing catheter care at home, Navi Nurses specializes in bridging that gap between fear and confidence. Whether that means hands-on catheter care, caregiver training, or simply having a skilled nurse in your corner to catch problems early—we're here to make sure your loved one gets the care they deserve.

Contact us at 480-482-1891 or navinurses.com/contact to learn more.