Potentially inappropriate urinary catheter indwelling among long‐term care facilities residents

Chen, Yi Tsun; Lin, Ming Hsien; Lai, Hung-Wen; Hwang, Shinn Jang; Chen, Liang Kung

doi:10.1111/j.1365-2753.2008.01055.x

Cited by 8 publications

(7 citation statements)

References 30 publications

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“…Previous studies revealed that the prevalence of indwelling urinary catheters or nasogastric tube insertion among long-term care facility residents in Taiwan is higher than that in the United States and European countries [26-29]. Long-term placement of urinary catheters or enteral feeding through nasogastric tubes can cause patient discomfort and lead to complications such as tube dislodgement, mucosal injury, infection and pressure ulcers, resulting in a decreased quality of life [26,30]. The rate of tube replacement of home healthcare patients in Taiwan deserves more attention.…”

Section: Discussionmentioning

confidence: 99%

Home healthcare services in Taiwan: a nationwide study among the older population

Chang

Lai

Hwang

et al. 2010

BMC Health Serv Res

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BackgroundHome healthcare services are important in aging societies worldwide. The present nationwide study of health insurance data examined the utilization and delivery patterns, including diagnostic indications, for home healthcare services used by seniors in Taiwan.MethodsPatients ≥65 years of age who received home healthcare services during 2004 under the Taiwanese National Health Insurance Program were identified and reimbursement claims were analyzed. Age, gender, disease diagnoses, distribution of facilities providing home healthcare services, and patterns of professional visits, including physician and skilled nursing visits, were also explored.ResultsAmong 2,104,978 beneficiaries ≥65 years of age, 19,483 (0.9%) patients received 127,753 home healthcare visits during 2004 with a mean number of 6.0 ± 4.8 visits per person. The highest prevalence of home healthcare services was in the 75-84 year age group in both sexes. Females received more home healthcare services than males in all age groups. Cerebrovascular disease was the most frequent diagnosis in these patients (50.7%). More than half of home healthcare visits and around half of the professional home visits were provided by community home nursing care institutions. The majority of the home skilled nursing services were tube replacements, including nasogastric tubes, Foley catheter, tracheostomy, nephrostomy or cystostomy tubes (95%).ConclusionsNine out of 1,000 older patients in Taiwan received home healthcare services during 2004, which was much lower than the rate of disabled older people in Taiwan. Females used home healthcare services more frequently than males and the majority of skilled nursing services were tube replacements. The rate of tube replacement of home healthcare patients in Taiwan deserves to be paid more attention.

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Section: Discussionmentioning

confidence: 99%

Home healthcare services in Taiwan: a nationwide study among the older population

Chang

Lai

Hwang

et al. 2010

BMC Health Serv Res

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Section: Discussionmentioning

confidence: 99%

“…13 However, many urinary catheters among residents in long-term care facilities in Taiwan were potentially removable. 13 In Europe, the prevalence of long-term urinary catheter use in elderly home care recipients ranged from 0 to 23% in 11 different countries. 16 In this study, the prevalence of long-term urinary catheter use is significantly higher than European countries, and is higher than the previous report from Taiwan.…”

Section: Discussionmentioning

confidence: 99%

“…Demographic profiles, functional status, past medical history, diuretics use, and renal function of each participant were obtained, and long-term urinary catheter placement was defined as the duration of urinary catheterization for more than 6 months. 13 The inclusion criteria according to the reimbursement of National Health Insurance are as follows: (1) participants maintain limited abilities of self-care ability, i.e., more than 50% of their daily activities were confined to bed or chair during awaking hours; (2) in needs of medical or skilled nursing care; (3) chronic conditions that require long-term nursing care, or (4) in need of post-acute nursing care after hospital discharge. Participants with following conditions would be excluded for study: (1) capable of voiding voluntarily; (2) supra-pubic urinary catheters indwelling; (3) having signs or symptoms of systemic or local infections; and (4) refuse to participate in the study.…”

Section: Participantsmentioning

confidence: 97%

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Evaluating the potential of removing long-term urinary catheters among home care recipients in Taiwan

Lin

Jao

Shin

et al. 2011

Journal of Clinical Gerontology and Geriatrics

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a b s t r a c tBackground: Urinary catheter placement is a common treatment choice for incontinent people. In Taiwan, urinary catheterization is a common care need for people receiving home care services, but the appropriateness of long-term urinary catheterization in this setting deserves extensive evaluation. Purpose: The main purpose of this study is to evaluate the potential of removing long-term placed urinary catheters among home-care recipients. Methods: Home care recipients with long-term urinary catheterization of a tertiary medical centre in Taichung were invited for study. For all participants, urinary catheters were removed for 4 hours before replacing a new catheter. Residual volume was measured to determine the ability of removing urinary catheters. Results: In total, 43 home care recipients (mean age: 80.3 AE 10.2 years, 37.2% men) participated in this study, and most of them were physically dependent [Eastern Cooperative Oncology Group (ECOG) Grade 3 for 48.8% and Grade 4 for 51.2%] and 69.8% were long-term catheterized. After removing urinary catheters, no self-voiding was observed and the mean residual-urine volume was 162.5 AE 9.6 cc during 4-hour observation. The mean residual-urine volume of the more dependent participants (ECOG Level 4) was significantly higher than the less dependent recipients (ECOG Level 3) (166.3 AE 12.5 vs. 157.5 AE 8.1 cc, p ¼ 0.004). Comparing recipients with residual urine volume higher and lower than 160 cc, we found that recipients with higher residual-urine volume were more likely to be people with diabetes (72.7% vs. 19.0%, p ¼ 0.001) and higher dependence (ECOG Grade 4) (72.7% vs. 28.6%, p ¼ 0.01). Conclusion: In conclusion, none of the long-term urinary catheterized home care recipients in this study demonstrated the ability of self-voiding, and those who had a residual-urine volume more than 160 cc were more likely to be people with diabetes and physical dependence. Further prospective interventional study is needed to evaluate the possibility of removing long-term urinary catheters among home care recipients in Taiwan.

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“…However, the most important method of prevention of CAUTI is to use an IUC only when necessary (appropriate) and to remove them when no longer indicated (Meddings et al, 2014). Inappropriate urethral catheterisation use is well documented in the literature in both acute (Chang, 2014; Gokula et al, 2004; Jansen et al, 2012; Tiware et al, 2012) and long-term care settings (Chen et al, 2009; Dingwall and McLafferty, 2006; Lomas et al, 2009; McNulty et al, 2006). Gokula et al (2004) report inappropriate use in 54% of catheterised patients, and of those catheterised only 13% had an explicit documented reason.…”

Section: Introductionmentioning

confidence: 99%

Point prevalence survey of indwelling urinary catheter use and appropriateness in patients living at home and receiving a community nursing service in Ireland

Forde

Barry

2017

Journal of Infection Prevention

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This study adds to the understanding of IUCs in patients at home and is the first to investigate if the IUC is appropriate in this setting. It prompted a review of current guidance and development of standard documentation for IUC management locally to ensure that the IUC in use is appropriate. It also suggests that there is a need for internationally accepted, appropriate indications for long-term IUC use to facilitate consistency and allow comparison across studies in future.

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Potentially inappropriate urinary catheter indwelling among long‐term care facilities residents

Cited by 8 publications

References 30 publications

Home healthcare services in Taiwan: a nationwide study among the older population

Home healthcare services in Taiwan: a nationwide study among the older population

Evaluating the potential of removing long-term urinary catheters among home care recipients in Taiwan

Point prevalence survey of indwelling urinary catheter use and appropriateness in patients living at home and receiving a community nursing service in Ireland

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