Which nursing interventions best reduce catheter-associated urinary tract infections for a patient with an indwelling catheter?

• A. Open drainage system; keep collection bag below bladder.
• B. Maintain a closed drainage system, keep collection bag below bladder, secure catheter, perform perineal hygiene, and remove catheter as soon as clinically appropriate.
• C. Secure catheter and perform perineal hygiene, but do not change collection bag.
• D. Remove catheter after 48 hours.

Answer: (B)

Preventing catheter-associated urinary tract infections hinges on keeping the catheter environment as closed and secure as possible and minimizing how long the catheter stays in place. Maintaining a closed drainage system protects the urinary tract from pathogens traveling along the catheter. Keeping the collection bag below the bladder uses gravity to prevent backflow and contamination. Securing the catheter prevents movement and urethral trauma that can introduce bacteria. Perineal hygiene reduces the chance of organisms from the skin migrating toward the catheter. Removing the catheter as soon as it’s clinically appropriate minimizes exposure time and infection risk. An open drainage system or leaving the bag unmanaged increases contamination risk, and sticking to a fixed removal time like 48 hours doesn’t account for the individual patient’s needs.