OBJECTIVES: CAUTI is one of the most common, costly, and preventable healthcare-associated infections. CAUTIs result from pathogens entering the urinary tract via indwelling urinary catheters (IUCs). Recently, FECs have been developed as alternatives to IUCs – IUCs can be removed and substituted with FECs in appropriate female patients. A patient will use a single IUC for their stay or course of treatment while FECs must be replaced periodically. The objective of this review and model is to assist organizations in estimating whether FECs offer either/both clinical and economic benefits.

METHODS: A systematic review of research published from 2016 through 2021 (PubMed and Embase databases) assessed the impact of utilization of FECs on organizations’ CAUTI rates. The results were analyzed and applied to a model to estimate the CAUTI cost avoided per day when a FEC is substituted for an IUC.

RESULTS: 270 records were identified. After exclusions, 25 records were reviewed. After excluding records that evaluated the FEC as part of a larger CAUTI prevention bundle, or failed other criteria (denominator issue, case study, or review paper), 8 records were analyzed. 3 studies reported multiple findings (multiple units, multiple hospitals, or multiple evaluation periods). Of the 11 results, 1 reported an increase in CAUTI after implementation of a program to utilize FECs; the remaining 10 reported decreases ranging from an 18.9% to a 100% reduction in the incidence of CAUTI. When applied to the model, the average economic benefit per IUC-day avoided ranged from $5.71 to $30.21 with a mean value of $23.38 per day.

CONCLUSIONS: Utilization of FECs as substitutes for IUCs, in appropriate patients, is likely to reduce an organization’s incidence of CAUTI. Further, the economic benefit may be favorable depending on the baseline incidence of CAUTI, the organization’s cost of CAUTI, and the actual CAUTI reduction achieved.