Effect of a Female External Urinary Catheter on Incidence of Catheter-Associated Urinary Tract Infection

Abstract

Background Catheter-associated urinary tract infections (CAUTIs) can be fatal, and are a source of avoidable expense for patients and hospitals. Prolonged catheterization increases infection risk, and avoiding catheters is crucial for infection prevention. Male external urinary catheters are recommended as a tool to prevent the need for indwelling catheterization. Female external urinary catheters (FEUCs) have intermittently been marketed without wide adoption; one has recently become available but published data is limited. Objective This retrospective observational study was conducted to investigate the effect of FEUCs on indwelling catheter use and female CAUTIs. Methods FEUCs were introduced to intensive care units. CAUTI rates and indwelling catheter days were obtained before and after the introduction of the devices. Results CAUTI rates decreased from 3.14 per 1000 catheter days to 1.42 per 1000 catheter days (p=0.013). Female indwelling catheter days decreased, while overall intensive care patient days increased. Conclusions Introduction of a FEUC was associated with a statistically significant decrease in CAUTI rate among female intensive care patients. The FEUC may prevent the need for indwelling catheters in some situations.

Effect of external urinary collection device implementation on female surgical patients

“…have not been, instead of decreasing UTI risk by removing an IUC. This contrasts with Rearigh's studies which showed a decrease in IUC days with EUCD introduction despite no change in CAUTI [14,17]. In support of this, the majority of patients who received an EUCD previously received an IUC.…”

“…This study contrasts with prior predominantly medical population single-institution studies that have demonstrated a decrease in CAUTI rates after EUCD introduction [14e17]. Zavodnick et al showed that EUCD implementation in a medical ICU decreased CAUTI rates by more than half [14]. Eckert et al found similar results at a community hospital with the CAUTI rate decreasing from 1.11 device-days to zero in the year following EUCD implementation [15].…”

Efficacy, effectiveness, usability and acceptability of devices for female urinary incontinence: A scoping review

“…Twenty‐one articles were selected among which 2 systematic reviews (Lipp et al, 2014; Mugita et al, 2021), 1 randomised controlled trial (Sugama et al, 2012), 1 quasi experimental study (Teerawattananon et al, 2015), 1 prospective interventional cohort study (Moore et al, 2021), 1 prospective descriptive study (Motta & Milne, 2017), 2 cross‐sectional descriptive studies (Grzybowska & Wydra, 2017; Gümüşsoy et al, 2019), 2 retrospective studies (Warren et al, 2021; Zavodnick et al, 2020), 1 product evaluation trial (Long et al, 2015), 1 pilot study (Jeong et al, 2016), 1 open‐label uncontrolled trial (Farage et al, 2011), 1 cost analysis study (Fader et al, 2010), 1 quality improvement project (Eckert et al, 2020), 1 qualitative study (Ostaszkiewicz et al, 2018; Raepsaet et al, 2021), 1 case study (Beeson & Davis, 2018), 4 conference paper (Dublynn & Episcopia, 2019; Fritsch et al, 2019; Maydick‐Youngberg et al, 2020; Mueller, 2019; Peters et al, 2021).…”

“…Population included in the studies was women with severe urinary incontinence recruited in urogynaecology outpatients (Grzybowska & Wydra, 2017; Gümüşsoy et al, 2019), women with all incontinence type (Lipp et al, 2014), patients with all incontinence types both urinary and faecal (Mugita et al, 2021), older women with urinary incontinence recruited from outpatient clinics and general practice surgeries (Long et al, 2015), older women with urinary incontinence in geriatric medical hospital (Sugama et al, 2012), women with both urinary and faecal incontinence and their caregivers in rehabilitation unit (Teerawattananon et al, 2015), women and caregivers at home (Jeong et al, 2016), women in intensive care unit (Beeson & Davis, 2018; Mueller, 2019; Warren et al, 2021; Zavodnick et al, 2020), women in burn care unit (Peters et al, 2021), women in no intensive hospital setting (Mueller, 2019; Warren et al, 2021), women in bed community hospital (Dublynn & Episcopia, 2019; Eckert et al, 2020), patients in a skilled nursing facility (Motta & Milne, 2017). One study explores nursing home staff members' beliefs and expectations about what constitutes “quality continence care” for people living in nursing, included registered nurses, enrolled nurses and personal care workers in a nursing home (Ostaszkiewicz et al, 2018).…”

“…The devices explored in the studies were as follows: female external urinary catheter, an external device used to manage urinary incontinence in a no‐invasive way in women without cognitive impairment, faecal incontinence, perineal wounds or even with menstruation (Beeson & Davis, 2018; Dublynn & Episcopia, 2019; Eckert et al, 2020; Fritsch et al, 2019; Mueller, 2019; Peters et al, 2021; Warren et al, 2021; Zavodnick et al, 2020); pads, disposable diapers or under‐pads used to manage both urinary and faecal incontinence in women and men (Grzybowska & Wydra, 2017; Gümüşsoy et al, 2019; Ostaszkiewicz et al, 2018; Sugama et al, 2012; Teerawattananon et al, 2015); mechanical devices, such as a continence dish, positioned to sit underneath the urethra, creating a support similar to the sub urethral sling, such as pessary or disposable intravaginal device, a single‐use and disposable device, which provide tension‐free support whenever the pressure is transferred from the abdominal cavity to the pelvic floor, or such as tampon (Farage et al, 2011; Lipp et al, 2014; Moore et al, 2021), a new prototype of underwear described as a pair of washable fixation pants with sewn‐in conductive threads that track where pads leak (Long et al, 2015), reusable underwear market for light incontinence (urinary leakage volumes up to approximately 25–30 ml daily), designed to be worn all day and machine washable (Alam et al, 2020), a new intelligent system pad, a system comprises of a urine collection cup made of medical‐grade silicone, a connecting hose between the urinal cup and the main body (Jeong et al, 2016). A summary of results is reported in Table 2.…”