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| N=130 (%) | Mean Duration of Use in Days ±SD | |
| Non-urologic Surgeries | 35 (26.9) | 1.51 ±1.20 |
| Unknown | 20 (15.4) | 2.50 ±1.89 |
| Accurate output measurement | 17 (13.1) | 4.00 ±2.62 |
| Acute Mental Status Changes | 16 (12.3) | 5.69 ±4.69 |
| Shortness of Breath | 12 (9.2) | 3.83 ±3.66 |
| Immobility | 9 (6.9) | 9.67 ±7.19 |
| Patient Request | 6 (4.6) | 2.67 ±2.42 |
| Incontinence | 6 (4.6) | 4.33 ±1.75 |
| Hypoxia requiring ≥6l/min oxygen | 4 (3.1) | 4.00 ±3.56 |
| Dementia | 2 (1.5) | 3.00 ±2.83 |
| Morbid Obesity | 2 (1.5) | 13.00 ±7.07 |
| Nursing Convenience | 1 (0.8) | 2.00 |
| N=143 (%) | Mean Duration of Use in days ± SD | |
| Neurogenic Bladder | 48 (33.6) | 4.29 ±4.26 |
| Chronic Urinary Catheter from Nursing Home | 31 (21.7) | 8.10 ±6.08 |
| Urologic Procedures | 27 (18.9) | 4.07 ±4.70 |
| Obstruction | 21 (14.7) | 5.76 ±6.85 |
| End of Life/ Palliative Care | 13 (9.1) | 6.31 ±3.09 |
| Immobilization Related to Trauma | 2 (1.4) | 3.00 ±1.41 |
| Sacral and Perineal Wounds with Incontinence | 1 (0.7) | 3.0 |
Background: Compliance with appropriate urinary catheter (UC) utilization in the non-intensive care units is essential to reduce risk for catheter-associated urinary tract infections.
Objective: To evaluate compliance with guidelines for the use of UCs in non-intensive care units, risk factors for inappropriate utilization, and duration of UC utilization for patients with and without an appropriate indication.
Methods: The study is a prospective observational study of patients on six non-intensive care units for 6 weeks. Patients were monitored during weekdays for the presence of a UC. The patient’s bedside nurse was asked for reason for UC use, whether the patient was immobile, had dementia, or incontinence. Data collected included: age, gender, reasons for placement, and duration of utilization. No intervention to discontinue UCs was done.
Results: 273 patients with UCs were included, with a mean age of 68.8±17.1 years, and 157 (57.5%) of female gender. UC use was indicated in 143 (52.4%) of the cases. When evaluating those placed during same admission, 102 (44%) were indicated. Nurses reported the patients to be immobile in 164 (60.1%), having dementia in 83 (30.4%), and having a history of incontinence in 62 (22.7%) of the cases. However, these 3 factors accounted for only 17 of 130 (13.1%) of cases that had a UC without appropriate indication. Female gender and age 80 years or older were independently associated with inappropriate UC utilization. The mean duration of utilization was longer for those with an indication (including chronic UC use) with a mean of 5.45±5.28 days compared to 3.75±3.96 days for those with no appropriate indication (p=0.003) (Tables 1 and 2).
Conclusions: Compliance with the published guidelines for UC utilization is poor in the non-intensive care units. Duration of use depends on the reason for placement and may be longer for patients with an appropriate indication.