US Hospitals Expanded CAUTI Prevention Practices, but Implementation Gaps Persist

A JAMA Network Open survey study examined 20-year trends in reported catheter-associated urinary tract infection (CAUTI) prevention practices in US hospitals. Six repeated cross-sectional surveys, conducted every four years from 2005 through 2025, targeted lead infection preventionists at all Veterans Affairs (VA) hospitals and a random sample of nonfederal general medical and surgical hospitals with intensive care units. Overall, 1,461 unique hospitals participated in at least one survey.

In nonfederal hospitals, regular use of catheter reminders or stop orders increased from 9.1% in 2005 to 48.7% in 2025; corresponding VA figures were 11.1% and 31.5%. Nurse-initiated catheter discontinuation increased from 11.3% in 2009 to 58.3% in 2025 in nonfederal hospitals, compared with 14.5% to 37.8% in VA hospitals. By 2025, regular use of external catheters in women was reported by 62.6% of nonfederal and 41.1% of VA hospitals. CAUTI surveillance systems were reported by 98.1% and 98.7%, respectively.

The findings identify persistent implementation gaps in practices intended to limit unnecessary catheter exposure, despite widespread surveillance infrastructure. However, the study measured reported practice use rather than infection outcomes, so it does not establish reductions in CAUTI. Mean response rates were 63.4% for VA and 56.5% for nonfederal hospitals; self-reporting, nonresponse, and changing respondents across survey waves may affect interpretation.