Clinical Scorecard: Catheter stop orders may be losing ground

At a Glance

Key Highlights

• Regular use of catheter reminders or stop orders in 2025 was below earlier peaks: 49% of nonfederal hospitals and 32% of VA hospitals reported use.
• In 2025, nurse-initiated catheter discontinuation was reported by 58% of nonfederal hospitals and 38% of VA hospitals.
• At least one reminder, stop-order, or nurse-initiated discontinuation strategy was regularly used by 69% of nonfederal hospitals and 49% of VA hospitals in 2025.
• By 2025, established CAUTI surveillance systems were reported by 98% of nonfederal hospitals and 99% of VA hospitals.
• The study measured reported prevention practices, not infection rates or patient outcomes, and therefore does not establish clinical effects of changing practice patterns.

Guideline-Based Recommendations

Diagnosis

Management

• The article reports that guidelines do not recommend routine use of silver alloy Foley catheters.
• The study authors cite systematic reviews reporting approximately 50% lower CAUTI rates with catheter reminders or stop orders.

Monitoring & Follow-up

• Daily rounds to assess catheter necessity were reported by 83% of nonfederal hospitals and 66% of VA hospitals in 2025.
• Routine monitoring of catheter duration and discontinuation increased between 2005 and 2025, reaching 87% of nonfederal hospitals and 73% of VA hospitals.

Risks

• Catheterization duration is described as a major modifiable risk factor for harm.
• Evidence on the effect of external urinary catheters on CAUTI rates is limited; the article identifies skin injury, device-associated urinary tract infections, and cost-effectiveness as areas needing further study.

Patient & Prescribing Data

The study surveyed hospital infection preventionists about reported CAUTI prevention practices; it did not evaluate individual patients or patient outcomes.

The article reports hospital-level use of catheter removal strategies and alternatives. It provides no patient-specific prescribing or treatment data.

Clinical Best Practices

• Assess catheter necessity during daily rounds, as reported by hospitals in the study.
• Use catheter reminders, stop orders, or nurse-initiated discontinuation strategies to support timely catheter removal; the article cites systematic reviews reporting lower CAUTI rates with reminders or stop orders.
• Monitor which patients have urinary catheters and track catheter duration and discontinuation.
• Do not routinely use silver alloy Foley catheters, consistent with the guidelines described in the article.
• Interpret the survey findings as reported practice patterns, not evidence of changes in CAUTI rates or patient outcomes.

Related Resources & Content

• JAMA Network Open study (source identified in article; URL not provided)