Switching From Saline Solution to an Antimicrobial Solution for Pre-Catheter Skin Cleansing

Abstract

The Infection Prevention and Control team at Rotherham Foundation Trust made the decision to switch from saline solution to an antimicrobial solution for skin cleansing prior to urinary catheterisation. The first stage of the switch has taken place in the community, with secondary care likely to follow suit at a later stage. The rationale for the switch, the two year journey it took to implement the changes and the parameters by which the success of the switch will be evaluated, are discussed in this article.
Catheter-associated urinary tract infections (CAUTI) are a cause of considerable concern and any measures which can be taken to potentially reduce the rate of CAUTI’s should be given careful consideration. In 2012 the Infection Prevention and Control team at Rotherham Foundation Trust switched from saline solution to an antimicrobial solution (Octenilin® cleaning solution sachets) for skin cleansing prior to urinary catheterisation to try to reduce CAUTI’s. Initially, Octenilin cleansing solution sachets were intended for use solely for patients with a current or historical confirmed result of MRSA in the urine and/or other sites. However, use has been extended to other patients, including those with a history of E. coli or Klebsiella, Gram-negative organisms frequently identified as a source of UTI’s. Early feedback from using Octenilin cleansing solution sachets in place of saline solution has indicated a high level of satisfaction from both patients and health-care professionals. Reports of catheterisation-associated trauma have reduced significantly and no CAUTI’s have been identified to date.