Optimising interventions for catheter-associated urinary tract infections (Cauti) in primary, secondary and care home settings

Marta Wanat*, Aleksandra J. Borek, Lou Atkins, Anna Sallis, Diane Ashiru Oredope, Elizabeth Beech, Christopher C. Butler, Tim Chadborn, Susan Hopkins, Leah Jones, Cliodna McNulty, Nia Roberts, Karen Shaw, Esther Taborn, Sarah Tonkin-crine

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Catheter-associated urinary tract infections (CAUTI) are common yet preventable. Healthcare professional behaviours, such as reducing unnecessary catheter use, are key for preventing CAUTI. Previous research has focused on identifying gaps in the national response to CAUTI in multiple settings in England. This study aimed to identify how national interventions could be optimised. We conducted a multi-method study comprising: a rapid review of research on interventions to reduce CAUTI; a behavioural analysis of effective research interventions compared to national interventions; and a stakeholder focus group and survey to identify the most promising options for optimising interventions. We identified 37 effective research interventions, mostly conducted in United States secondary care. A behavioural analysis of these interventions identified 39 intervention components as possible ways to optimise national interventions. Seven intervention components were prioritised by stakeholders. These included: checklists for discharge/admission to wards; information for patients and relatives about the pros/cons of catheters; setting and profession specific guidelines; standardised nationwide computer-based documentation; promotion of alternatives to catheter use; CAUTI champions; and bladder scanners. By combining research evidence, behavioural analysis and stakeholder feedback, we identified how national interventions to reduce CAUTI could be improved. The seven prioritised components should be considered for future implementation.

Original languageEnglish
Article number419
Pages (from-to)1-13
Number of pages13
Issue number7
Publication statusPublished - Jul 2020

Bibliographical note

Funding Information:
Funding: This study was commissioned and funded by Public Health England Behavioural Insights, and was carried out as a collaboration between the University of Oxford, Public Health England and University College London. S.T.‐C. was supported by funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England [HPRU‐2012‐10041].

Publisher Copyright:
© 2020 by the authors.  Licensee MDPI, Basel, Switzerland.


  • Behavioural analysis
  • Behaviour change techniques
  • Behaviour change wheel 
  • Catheterassociated urinary tract infections
  • Qualitative
  • Rapid  review
  • Theoretical domains framework


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