Prevalence and appropriateness of indwelling urinary catheters in Japanese hospital wards: a multicenter point prevalence study

Abstract

Background Indwelling urinary catheters are commonly used in hospitalized patients, which can lead to the development of urinary catheter complications, including catheter-associated urinary tract infection (CAUTI). Limited reports on the appropriateness of urinary catheter use exist in Japan. This study investigated the prevalence and appropriateness of indwelling urinary catheters, and the incidence of CAUTI in non-intensive care unit (non-ICU) wards in Japanese hospitals. Methods This prospective observational study was conducted in 7 non-ICU wards from 6 hospitals in Japan from October 2017 to June 2018. At each hospital the study teams evaluated urinary catheter prevalence through in-person bedside evaluation for at least 5 days of each week for 3 months. Catheter associated urinary tract infection (CAUTI) incidence and appropriateness of catheter use was collected via chart review. Results We assessed 710 catheter-days over 5528 patient-days. The mean prevalence of indwelling urinary catheter use in participating wards was 13% (range: 5% to 19%), while the mean incidence of CAUTI was 9.86 per 1000 catheter-days (range: 0 to 33.90). Approximately 66% of the urinary catheter days assessed had an appropriate indication for use (range: 17% to 81%). A physician's order for catheter placement was present in only 10% of catheterized patients. Conclusion This multicenter study provides epidemiological information about the appropriate use of urinary catheters in Japanese non-ICU wards. A multimodal intervention may help improve the appropriate use of urinary catheters.

Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: 2022 Update

“…Often, these devices are placed and maintained in use without an appropriate clinical indication to justify the risk compared to the benefit. [6][7][8][9][10] Also, 12%-16% of adult hospital inpatients will have an indwelling urethral catheter at some point during admission. 11 Of patients who have a urinary catheter placed in the hospital, up to half are placed in patients who may not have an appropriate indication for a urinary catheter.…”

Urinary catheter placement and adverse urinary outcomes with a focus on elevated risk in men with indwelling Foley catheters

“…Based on the statistical data from the National Healthcare Safety Network, it is estimated that approximately 15%-25% of patients in the United States are subjected to urinary catheterization during their hospitalization. 2 The prevalence of urinary catheterization among hospitalized patients is recorded at approximately 13% in Japan, 3 14.9% in Korea, 4 and 15% in Taiwan. 5 However, urinary catheterization carries the risk of various complications, including UTIs, bladder spasms, and urinary malignancy.…”