Urinary Catheters: What Type Do Men and Their Nurses Prefer?

Saint, Sanjay; Lipsky, Benjamin A.; Baker, PN; McDonald, Linda L.; Ossenkop, Kathleen

doi:10.1111/j.1532-5415.1999.tb01567.x

Cited by 93 publications

(53 citation statements)

References 26 publications

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“…A randomized trial demonstrated a decrease in bacteruria, symptomatic UTI, and death in patients with condom catheters compared with those with indwelling catheter. 180,[188][189][190][191] Proper techniques for insertion and maintenance of catheters are essential preventative measures. All urinary catheters should be inserted by a trained health care professional using aseptic technique and connected to a closed drainage system.…”

Section: Risk Factorsmentioning

confidence: 99%

Infection Control in the Intensive Care Unit

Osman

Askari

2014

Surgical Clinics of North America

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Section: Risk Factorsmentioning

confidence: 99%

Infection Control in the Intensive Care Unit

Osman

Askari

2014

Surgical Clinics of North America

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“…English-or Spanish-speaking patients arriving for a visit with one of 41 physicians at an urban academic medical center from February 1998 through August 2000 were asked to complete a written alcohol screening test before the physician visit, to assess eligibility for a randomized trial of a systems intervention in primary care (7). Physicians were primary care internal medicine residents and faculty.…”

Section: Methodsmentioning

confidence: 99%

“…Bacteremia occurs in 1% to 4% of those who develop nosocomial bacteriuria (6). Most patients also find an indwelling urinary catheter to be uncomfortable and activity restricting (7). Given these potential morbidities, it is remarkable how infrequently the use of a urinary catheter is documented by a physician's order in the medical record (8).…”

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confidence: 99%

Computer-based order entry decreases duration of indwelling urinary catheterization in hospitalized patients

Cornia

Amory

Fraser

et al. 2003

The American Journal of Medicine

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U p to 25% of hospitalized patients will have an indwelling urinary catheter inserted (1). While most of these catheters are required for optimal patient care, about one in five is unnecessary (2). Catheter-related urinary tract infections are the leading cause of nosocomial infection. They account for up to 40% of hospital-acquired infections, with an incidence of 3% to 10% per day of indwelling catheterization (1,(3)(4)(5). Bacteremia occurs in 1% to 4% of those who develop nosocomial bacteriuria (6). Most patients also find an indwelling urinary catheter to be uncomfortable and activity restricting (7). Given these potential morbidities, it is remarkable how infrequently the use of a urinary catheter is documented by a physician's order in the medical record (8).The strongest predictor for catheter-associated bacteriuria is the duration of catheterization (3,4). Thus, methods to shorten this period should reduce the risk of nosocomial urinary tract infection, yet physicians are often unaware that their own hospitalized patients have a urinary catheter in place (9). Furthermore, these "forgotten" catheters were about twice as likely to be unnecessary as those remembered by the physician (9). Thus, a system that would remind physicians which of their patients had urinary catheters might shorten the duration of catheterization.One such approach involves using automatic reminders to physicians through computerized medical record systems (10 -15). At our Veterans Affairs (VA) medical center, nearly all patient records and orders are entered into a computer. We hypothesized that a computer-based order for inserting an indwelling urinary catheter, combined with computer-generated reminders to remove the catheter, would improve documentation of urinary catheters, alert physicians that the catheter was in place, and encourage discontinuing catheterization that was no longer required. METHODSAll inpatients at the VA Puget Sound Health Care System are cared for by teams of resident physicians supervised by University of Washington faculty. Patients on the medicine and cardiology services are predominantly housed on two hospital wards (second and fourth floor), with most of each team's patients on a single ward. During the first 8 weeks of the study, the fourth floor served as the study ward and the second floor served as the control ward; during the second 8 weeks, the second floor became the study ward and the fourth floor became the control.At the beginning of each month, a training session is held to teach incoming residents about the computer system. During this session, one of the investigators (PBC) explained the purpose of the study, including the direct association between duration of catheterization and catheter-associated urinary tract infection, and instructed residents on use of the computerized urinary catheter study order. We also explained the purpose of the study to the ward nurses and encouraged them to remind physicians to place a computerized order for each indwelling urinary catheter. Physicians whos...

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“…2,3 The urinary catheter is also associated Inserting catheters only for appropriate indications and leavwith other patient safety problems, such as trauma, 4 increased ing in place only for as long as medically necessary is 1 of patient discomfort, 5 and immobility. 6 CAUTI prevention has the strong (category IB) recommendations.…”

mentioning

confidence: 99%

Regional Variation in Urinary Catheter Use and Catheter-Associated Urinary Tract Infection: Results from a National Collaborative

Greene

Fakih

Fowler

et al. 2014

Infect. Control Hosp. Epidemiol.

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OBJECTIVE. To examine regional variation in the use and appropriateness of indwelling urinary catheters and catheter-associated urinary tract infection (CAUTI). DESIGN AND SETTING. Cross-sectional study.PARTICIPANTS. US acute care hospitals.METHODS. Hospitals were divided into 4 regions according to the US Census Bureau. Baseline data on urinary catheter use, catheter appropriateness, and CAUTI were collected from participating units. The catheter utilization ratio was calculated by dividing the number of catheter-days by the number of patient-days. We used the National Healthcare Safety Network (NHSN) definition (number of CAUTIs per 1,000 catheter-days) and a population-based definition (number of CAUTIs per 10,000 patient-days) to calculate CAUTI rates. Logistic and Poisson regression models were used to assess regional differences.RESULTS. Data on 434,207 catheter-days over 1,400,770 patient-days were collected from 1,101 units within 726 hospitals across 34 states. Overall catheter utilization was 31%. Catheter utilization was significantly higher in non-intensive care units (ICUs) in the West compared with non-ICUs in all other regions. Approximately 30%-40% of catheters in non-ICUs were placed without an appropriate indication. Catheter appropriateness was the lowest in the West. A total of 1,099 CAUTIs were observed (NHSN rate of 2.5 per 1,000 catheter-days and a population-based rate of 7.8 per 10,000 patient-days). The population-based CAUTI rate was highest in the West (8.9 CAUTIs per 10,000 patient-days) and was significantly higher compared with the Midwest, even after adjusting for hospital characteristics (P = .02).CONCLUSIONS. Regional differences in catheter use, appropriateness, and CAUTI rates were detected across US hospitals.

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Urinary Catheters: What Type Do Men and Their Nurses Prefer?

Abstract: Both patients and nursing staff prefer condom to indwelling catheters for patient comfort, but they recognize that dislodgment and leaking are major drawbacks of condom catheters. A more secure condom catheter would greatly improve the management of male incontinence.

Cited by 93 publications

References 26 publications

Infection Control in the Intensive Care Unit

Infection Control in the Intensive Care Unit

Computer-based order entry decreases duration of indwelling urinary catheterization in hospitalized patients

Regional Variation in Urinary Catheter Use and Catheter-Associated Urinary Tract Infection: Results from a National Collaborative

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