OR / Perioperative

AHRQ-aligned work on catheter-associated urinary tract infection (CAUTI) prevention centers on a simple fact: catheter days drive infections. The most effective interventions limit indwelling urinary catheter use, insert only for appropriate indications, maintain a closed drainage system, and remove the catheter the moment it is no longer needed.

The strongest, most nurse-controlled lever is the nurse-driven removal protocol, which lets nurses remove a catheter that no longer meets criteria without waiting for a separate order. Daily review of necessity — paired with securement, hand hygiene, and keeping the bag below bladder level — is what brings rates down.

AORN's guideline on sterile technique reiterates the fundamentals that protect the surgical patient: establishing and maintaining the sterile field, correct gowning and gloving, careful handling of sterile items, and minimizing movement and door openings that disrupt airflow and raise contamination risk.

The guideline frames surgical site infection prevention as a team behavior, not a single step. Maintaining a wide margin around the sterile field, monitoring for and acting on breaks in technique, and limiting OR traffic each reduce the bioburden the patient is exposed to during a procedure.

Guideline guidance on pressure injury (pressure ulcer) prevention emphasizes structured risk assessment on admission and at regular intervals, paired with individualized prevention: repositioning, pressure-redistributing surfaces, skin inspection, and moisture and nutrition management.

The guidance stresses that prevention is ongoing and tailored to risk — higher-risk patients need more frequent repositioning and skin assessment, and early-stage skin changes should trigger escalation before they progress. Heels, the sacrum, and medical-device sites are common, watch-closely locations.