Integrative review: evidences on the practice of intermittent/indwelling urinary catheterization

Abstract

Objective: to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. Method: the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. Results: the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection.Conclusions: there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This review's results represent an updating of the nurse's conducts and decisionmaking for the prevention of urinary tract infections in urinary catheterization.

Incidence of Catheter-Related Urinary Tract Infecions: A Cohort Study

“…19 O papel do biofilme na patogênese da ITU ainda não é bem conhecido, porém pacientes em uso de cateteres impregnados com antibióticos ou com sais de prata apresentaram menores taxas de ITU. 20 A densidade de incidência de ITU neste estudo foi de 6,34/1.000 cateteres-dia. Este valor está em consonância com o achado de Rosenthal 21 e foi de 6,3 ITU/1.000 cateteres-dia, dados estes coletados pelo período de seis anos de informações sobre infecções associadas a dispositivos em UTI de hospitais da Amé-rica Latina, Ásia, África e Europa.…”

Comparison of 1 Versus 3 Days Post-Operative Catheterization After Anterior Colporrhaphy

“…Urinary retention after surgery is estimated by measuring if the quantity of urine retained is more than or equal to 200 ml by ultrasound 8 h after removing catheters 10,11 , or the remaining urine was estimated at 150 CC for patients who cannot empty their bladder 6 hours after removing the catheters 12 . Other complications related to surgery of anterior colporrhaphy are cathetersdependent urinary infections 13,14 that must be taken into consideration in estimating the time needed for keeping the catheters, because it is estimated as the cause of more than 30% of hospital infections 15 . Therefore, the urinary catheters are improvised for several days in order to prevent complications after surgery 16 .…”

<b>Reabilitação de crianças e adolescentes com mielomeningocele: relato de experiência de atuação da enfermagem/Rehabilitation of children and adolescents with myelomeningocele: nursing practice report<b>

“…Orienta-se a empinar a cadeira de rodas para superar obstáculos, as transferências da cadeira de rodas para o carrocama-chão-cadeira de banho, e vice-versa, utilizando-se tábuas de transferências, bem como a locomoção em ambientes acidentados, com ou sem aclive. Com supervisão profissional, os indivíduos são incentivados a locomover-se pelas ruas e calçadas da cidade e a utilizar o serviço de transporte público, trabalhando concomitantemente a participação como membros ativos na sociedade (13) .…”