Distinguish bruises from DTPIs

Pump up moisturization Urinary catheter practices:

Your goal is to keep patients safe from catheterassociated urinary tract infections( CAUTIs). You have protocols in place for everyone to follow. Yet practice variation still happens and CAUTIs still occur. What’ s going on? And how can you lower CAUTI rates?

Let’ s take a look at what Medline identified in 2022, starting with the placement of indwelling urinary catheters( IUCs).

Practice audits Of more than 2,500 IUC placements( in multiple US hospitals) 1:

90.4 %

Staff surveys Of more than 2,100 participants( from multiple US hospitals) 1:

Interventions or devices used if the patient is ordered for 24-hour intake / output

Why it matters: When urine output monitoring is needed to provide care but hourly measurement is not required, alternatives to indwelling catheters should be prioritized. 5

How often bladder scanner used to determine next steps for patient care

13.3 % of the time

Always

Why bladder scanner used

94.3 %

Patient has urine retention

Interventions used if the patient has not voided in 4-6 hours

89 %

Bladder scanner

45.8 %

Often Sometimes Rarely

91.1 %

To assess adequate bladder emptying

6.2 %

34.1 %

Why it matters: The most important risk factor for developing CAUTI is prolonged use of an IUC. Catheters should only be used for appropriate indications and should be removed as soon as they are no longer needed. 4

What you can do

Have a nurse-driven protocol enabling nurses to bladder scan and straight cath the patient without a physician order

Why it matters: Nurse-driven protocols and handheld bladder scanners have been shown to reduce the risk of CAUTI. A straight catheter can be used for one-time, intermittent or chronic voiding needs. 5

It’ s all about making education continuous. Keep the findings shown here in mind for future teachable moments. And make sure your protocols include clear processes that everyone can follow every time to prevent CAUTI.

© 2023 Medline Industries, LP. All rights reserved. Medline is a registered trademark of Medline Industries, LP. MKT19W4190285 / 49

Urinary catheter practices

Other

70.2 %

5.0 %

Foley isn’ t draining

3.3 %

Intermittent catheter

94.2 %

80.4 % of the time

IUC

63.4 %

Intermittent catheter 37.6 %

Female external catheter

Have a protocol for straight cath after an IUC is removed without post-op or physician set of orders

Why it matters: IUCs should be discontinued within 24 hours or less after surgery unless there is an appropriate indication for continued post-operative use. Straight cathing after IUC removal prevents urinary retention patients may have post-operatively. 5

Assess daily need for the IUC

1.8 %

Never

5.3 %

Other

1.5 %

IUC

Female urinal 50 %

Male urinal

76.8 %

73.5 % Male

51.2 % external catheter

73.2 %

61.2 % of the time

Unsure 21.9 %

No 36 %

Unsure 25.7 %

No 35 %

16.3 %

Diapers / Drypads

Bedpan

64.2 %

Yes 42.1 %

Yes 39.3 %

Have delayed removing the IUC if clinically indicated, due to competing priorities

References: 1. Data on file. Danek, G., et al.( 2015, May). 2. Prevalence of Dependent Loops in Urine Drainage Systems in Hospitalized Patients. Journal of Wound, Ostomy and Continence Nursing, 42( 3), 273 – 278. Prevalence of Dependent Loops in Urine Drainage Systems in Hospitalized Patients— PMC( nih. gov). 3. UroToday. Prevention of Catheter-associated Urinary Tract Infections through Evidence-based Management of Indwelling Urinary Catheters in Adult Patients. Retrieved May 5, 2023, from https:// www. urotoday. com / cauti-cha lenge-cdc-guidelines / 133949-prevention-of-catheter-associated-urinary-tract-infections-through-evidence-based-management-of-indwelling-urinary-cathetersin-adult-patients. html. 4. Meddings, J. Appropriate Use and Prompt Removal of Indwe ling Urinary Catheters. Centers for Disease Control and Prevention( CDC). Retrieved May 5, 2023, from https:// www. cdc. gov / infectioncontrol / pdf / strive / CAUTI102-508. pdf. 5. Agency for Healthcare Research and Quality( AHRQ). Toolkit for Reducing Catheter-Associated Urinary Tract Infections in Hospital Units: Implementation Guide. Retrieved May 5, 2023, from https:// www. ahrq. gov / hai / cauti-tools / guides / implguide-pt3. html

Actionable feedback

Advanced products

Every moment

Effective learning systems

Reliable delivery systems

Point of care access

Buzzworthy

Evelyn Narvaez, wound care lead for inpatient care at Martin Luther King Jr. Community Healthcare( MLKCH) in South Los Angeles, wanted to offer education that would engage her staff and empower them to help prevent pressure injuries. But developing a training program can be stressful and time-consuming. Fortunately, as a Medline customer, Narvaez and MLKCH had access to the Skin Champion program that accompanies the Medline products MLKCH purchases.

Narvaez did much of the planning and teaching, tailoring modules to MLKCH-specific policies and processes, while mixing in her own icebreakers, games and group activities.

The fact that all 25 nurses started and completed the program was unusual, and it was a success Narvaez felt was worth celebrating.“ They are now vital resources for our

facility, and it was essential that the entire hospital community knows who they are and the valuable role they play,” Narvaez comments.

The celebration that Narvaez planned, organized and put on included printed invitations and a stage for graduates to receive certificates. Leaders from across the organization, along with the graduates’ families and friends, filled the audience.

MLKCH was drawn to the Skin Champion program’ s instruction on the safe and effective use of Medline products, as well as the potential to help lower their HAPI rates, and they’ ve seen positive results.“ Most notably, we’ ve seen a remarkable decrease in state-reportable HAPI cases at our hospital since the program concluded in April [ 2025 ],” says Sandra Temple, MLKCH’ s senior director of nursing operations.“ It’ s so clear what we’ re getting out of it.”

Olga Pankova / Moment via Getty Images

Multimodal education guide

Support all learning styles to help reduce HACs.

Pair the right education type with staff learning preferences to help boost knowledge retention and make learning stick.

Step 1: Start with a clinical topic. Step 2: Choose a learning style that fits.

PI prevention

Nurses who learn best visually will benefit from infographics and posters.

Videos give auditory learners an effective way to process information.

Online coursework and e-books appeal to those who prefer reading.

Hands-on activities and real life examples work well for kinesthetic learners.

CAUTI prevention CLABSI prevention

By leveraging different types of instruction, multimodal education creates a more effective experience for clinicians at all levels of experience and skill. Definitions of multimodal learning typically include four types: visual, auditory, reading and kinesthetic. 1

“ If we can keep learners engaged, there will be buy-in and motivation to learn,” says Brenda Kozak,

DNP, MSN, RN, CNE, senior clinical education specialist at Medline. We created this guide to give you access to educational tools that support visual, auditory, reading and kinesthetic learning styles— education your staff needs to feel confident, follow facility protocols and reduce healthcare-associated conditions.

Skin champion and Skin Matters programs

Pressure injury prevention guide Case study in reducing HAPIs

Is your team always doing the right thing?

Bed sheet clamp was not used to secure the tubing

Why it matters: Bags attached to moveable objects increase trauma risk because of pulling. The catheter drainage bag can be placed near the bed’ s foot by securing tubing to the bottom sheet using the clip on the drainage tube to hook the bag on the bottom bed rail. 3

S M T T F S

© 2025 Medline Industries, LP. All rights reserved. Medline is a registered trademark of Medline Industries, LP. 19W6799468 / 100

Why it matters: This tool should be used to assess and confirm urinary retention before placing a catheter to address suspected urinary retention. Its use reduces unnecessary catheterization when the bladder’ s volume is not the cause of the patient’ s symptoms. 5

No label with date / time of insertion was placed on the drain bag or urine meter

Why it matters: A label sticker on a patient’ s catheter bag reminds caregivers that an IUC is still in use; it may also remind staff of appropriate indication to continue catheterization. 4

Catheter drainage bags were hung with dependent loops

Why it matters: Dependent loops trap drained urine and are suspected of impeding bladder drainage and increasing the residual volume of retained urine in the bladder. 2

External catheter selection Dependent loops Prepping an IUC drain bag

CAUTI prevention course

Case study in how partnerships help improve outcomes

Medline offers more than 10 unique, hands-on clinical education games to engage your nursing teams. Contact your Medline specialist for details.

Medline is here to help with our comprehensive Urological Solution.

CLABSI prevention checklist Hand hygiene essentials

essential elements of hand

hygiene ™

Central line insertion webinar CLABSI prevention course

Case study on CLABSI prevention

Reference 1 VARK Learn Limited.( 2024, April 26). Introduction to VARK ®: for better learning. VARK – Helping You Learn Better. https:// vark-learn. com / introduction-to-vark /

Download it here.

6 Healthy Skin Issue 16 / Fall 2025