Focus on Patient Safety - Catheters and healthcare-associated infections...Keeping a catheter in too long increases the chances of infection

Context

In 2022, based on the national survey on the prevalence of healthcare-associated infections, Santé publique France found that 33% of hospitalised patients are fitted with at least one catheter. Moreover, the French National Authority for Health evaluates the number of catheters inserted every year in France at 25 million, while the French national invasive device-related infection monitoring and prevention programme reports that 30% of the 9,103 identified cases of healthcare-associated bacteriaemia are catheter-related. Therefore, catheter insertion, use and management are common procedures, which may be the source of potentially severe local or systemic infections. This publication is incorporated within the framework of the 2002-2025 French national infection and antibiotic resistance strategy led by the French Ministry of Solidarity and Health. 

Objectives

By sharing feedback from professionals, this Focus on patient safety aims to draw the attention of and raise awareness among healthcare professionals and healthcare organisation managers as to the importance of ensuring best practice availability, accessibility and compliance for catheter use. 

So it doesn’t happen again

Based on the review of reported care-related serious adverse events, these events are most often caused by poor catheter use. 

Main key messages to prevent these events :  

• Systematically assess the relevance and the benefit-risk balance in respect of catheter insertion and reassess these criteria on a daily basis to decide on catheter retention. 
• Be vigilant in the presence of any sign of infection, learn to recognise atypical infectious signs in the most vulnerable patients and in particular in newborn infants. In the event of any sign of infection in a patient with a catheter, contamination must be suspected and the catheter removed (good practice guidelines). 
• Ensure that catheter-related daily clinical monitoring items are created and tracked in the patient record. 
• Make sure that regularly updated good practice guidelines in relation to catheters and relevant protocols are readily accessible for healthcare professionals. The protocols must be validated by the operational hygiene team. 
• Always assign catheter insertion, use, maintenance and removal to staff whose theoretical and practical skills are regularly assessed.