Urethral catheters are small tubes inserted through the urethra to drain urine. These devices are often linked to high rates of urinary tract infections (UTIs) and are frequently used in the elderly population. This contributes to longer hospital stays which lead to increased medical costs. In 2008, the Centers of Medicare and Medicaid Services (CMS) included catheter-associated bacteriuria (CAB) as one of the preventable hospital-acquired conditions (HACs) that will affect reimbursement if contracted by a patient in the acute and long-term setting. This document focuses on three evidence-based best practices and nursing strategies to prevent CAB. BackgroundVan Buren is the second largest city in the Fort Smith, Arkansas (AR)-Oklahoma (OK) metropolitan statistical area and is the county seat of Crawford County, AR. . The City of VanBuren has numerous subsystems dedicated to community well-being, which include one medical facility, five medical clinics, three nursing homes, three ambulance services, and the Crawford County Health Department (Yellow Pages, 2010). Summit Medical Center provides full-service general acute care to approximately 160,000 residents annually in Crawford, Franklin and Sebastian counties in AR and Sequoyah County in OK. The facility has 103 beds, a staff of over 100 nurses, and over 140 doctors in medical clinics (Summit Medical Center, 2011). In 2009, the medical facility's emergency department (ED) treated 170 residents from nursing homes, 70 of whom were admitted to the hospital after examination and treatment in the emergency department, 58 were treated as “outpatient emergency department” visits ” and 42 were direct inpatient visits (Summit MedicalCenter, 2011). Most... half of the paper... See Figure I). The decision tree is used to guide clinicians in making clinical decisions about whether to continue or discontinue indwelling urethral catheters. Conclusion Urethral catheterization in the elderly population should be considered as a last option because it can lead to catheter-associated bacteriuria, bloodstream infection, sepsis, and death. It should not be used for staff convenience or to manage urinary incontinence that can be managed by other means. CAB is a condition that can be prevented with the application of evidence-based best practice strategies. These include criteria for catheter placement and discontinuation, use of silver alloy catheters for short-term catheterization, and limitation of bladder irrigation. An algorithm for urethral catheter insertion, care, and removal is used as a tool to help prevent CABs and achieve better patient outcomes.