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Update on CMS CAUTI Guidelines for Patients with Spinal Cord Injury

Among the core measures subject to a financial penalty from the Centers for Medicare & Medicaid (CMS) is an above average rate of catheter-associated urinary tract infections (CAUTIs), which has prompted acute care hospitals around the country to enact policies to reduce the number of infections.

“By paying close attention to whether patients actually need a Foley catheter and by removing them when they don’t, hospitals and other care facilities have lowered their CAUTI rates,” says Matthew Davis, M.D., clinical director of the Spinal Cord Injury (SCI) Program at TIRR Memorial Hermann and a clinical professor of physical medicine and rehabilitation at McGovern Medical School at UTHealth. “But healthcare professionals outside the field of rehabilitation are often unaware that many SCI patients suffer from neurogenic bladder, which requires management either by indwelling catheters or by intermittent catheterization. Premature catheter removal combined with poorly implemented intermittent catheterization can have disastrous consequences for these patients.”

Dr. Davis has devoted considerable time during the past 18 months to raising awareness of the potentially negative effects of the CAUTI quality measure on patients with spinal cord injury. In March 2014, he urged physical medicine and rehabilitation specialists across the nation to participate in an open discussion held by the National Quality Forum (NQF) soliciting feedback about the measure.

As a result of these and other efforts by Dr. Davis and specialists in spinal cord injury from around the country, The Joint Commission has incorporated changes for which the SCI professionals have been advocating in their planned revisions to the CAUTI National Patient Safety Goal. For more information, visit www.jointcommission.org/topics/hai_cauti.aspx.