Bladder Matters: Indwelling Urinary Catheters: Common mechanical and pathogenic problems.
Eileen Toughill PhD, RN, APRN, C

$3.95
AJN, American Journal of Nursing
May 2005 
Volume 105  Number 5
Pages 35 - 37
 
  PDF Version Available!

ABSTRACT
Outline

  • MECHANICAL PROBLEMS

  • PATHOGENIC PROBLEMS

  • RECOMMENDATIONS

  • REFERENCES



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    Because of the high rates of morbidity and mortality associated with their use, long-term indwelling urinary catheters (catheters in place for seven days or longer) are recommended in very specific instances only. Unfortunately, they are often used inappropriately. Saint and colleagues found that 28% of physicians who were asked about their hospitalized patients didn’t know which ones had a catheter. 1 And Munasinghe and colleagues found that 38% (N = 34) of indwelling urinary catheters had no justifiable indication. 2

    Indwelling catheters are appropriate for use in treating urinary retention that can’t be treated by other methods, such as intermittent catheterization or medication, and for palliative care at the end of life. It’s also recommended in patients with stage 3 or 4 pressure ulcer of the trunk (once the ulcer is healed, the catheter is removed) and for measurement of urine volume in critically ill patients, such as those with renal failure. 3

    MECHANICAL PROBLEMS

    The type of material used for the indwelling urinary catheter may have some effect on long-term use, although research on the appropriate type and size of the catheter or balloon is scant. The long-term use of indwelling urinary catheters is associated with high rates of urinary tract infection and spasms. The most commonly used catheters are latex. 4 An all-silicone catheter, however, should be used in patients with an allergy to latex. Research on the use of silver-coated urinary catheters indicates that they may lead to fewer urinary tract infections than silicone or silicone-coated catheters and the more common hydrogel-coated latex ones. 5, 6 But additional research on their benefit for long-term catheterization is needed. ...

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