Nursing interventions designed to decrease the risk of infection in a client with an indwelling catheter include:

The most critical nursing intervention to reduce the risk of a catheter-associated urinary tract infection (CAUTI) is performing routine perineal hygiene. Cleansing the area around the urethral meatus and the adjacent catheter surface with soap and water or a designated cleanser at least twice daily and after any bowel movement is a standard of care. This practice effectively removes microorganisms at the insertion site, preventing their migration along the catheter into the bladder, which is a primary cause of CAUTIs.

B. The drainage bag should be emptied when two-thirds full or at least every 8 hours, not just daily, to prevent urine stasis and reflux.

C. The catheter and drainage system should only be changed when clinically indicated (e.g., obstruction, infection), not on a routine schedule, to maintain a closed system.

D. A fluid intake of 2000–2500 mL/day is generally recommended to promote urine flow and flush the bladder, unless contraindicated; 1200-1500 mL is insufficient.

1. Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2021). Fundamentals of nursing (10th ed.). Elsevier. In Chapter 46, "Urinary Elimination," the text specifies performing catheter care (cleansing the perineal area) at least twice daily and after defecation or bowel incontinence to reduce the risk of CAUTI (p. 1133). It also recommends emptying drainage bags when half to two-thirds full (p. 1133) and maintaining a fluid intake of 2000 to 2500 mL/day (p. 1127).

2. Gould, C. V., Umscheid, C. A., Agarwal, R. K., Kuntz, G., Pegues, D. A., & Healthcare Infection Control Practices Advisory Committee (HICPAC). (2010). Guideline for prevention of catheter-associated urinary tract infections 2009. Infection Control & Hospital Epidemiology, 31(4), 319-326. https://doi.org/10.1086/651091. In the "Catheter Care" section, the guideline states, "In patients with indwelling catheters, perform routine hygiene; daily cleansing of the meatal surface with soap and water is appropriate" (p. 323). It also recommends against routine catheter changes (p. 323).

3. Lo, E., Nicolle, L. E., Coffin, S. E., Gould, C., Maragakis, L. L., Meddings, J., ... & Yokoe, D. S. (2014). Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(5), 464-479. https://doi.org/10.1086/675718. This updated guideline reinforces the principle of maintaining a closed drainage system and states that "routine hygiene (e.g., cleansing of the meatal surface during daily bathing) is appropriate" (p. 471).