Managing long term indwelling urinary catheters

Murphy, Catherine; Cowan, Alex; Moore, Katherine; Fader, Mandy

doi:10.1136/bmj.k3711

Cited by 19 publications

(20 citation statements)

References 35 publications

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“…It is necessary to assess the effects of LTUC on clinical outcomes in the community as well as in the acute hospital setting. For appropriate management of LTUC, considering the indications of urinary catheterisation and alternatives were discussed in a recently published paper 9. Intermittent catheterisation is recommended for people with acceptable cognitive function and for people whose carers could assist in its implementation 9.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with long-term urinary catheterisation and its impact on urinary tract infection among older people in the community: a population-based observational study in a city in Japan

et al. 2019

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ObjectivesThis study aimed to identify factors associated with long-term urinary catheterisation (LTUC) in community-dwelling older adults and to evaluate the risk of urinary tract infection (UTI) among people with LTUC.DesignPopulation-based observational study.SettingMedical and long-term care insurance claims data from one municipality in Japan.ParticipantsPeople aged ≥75 years living at home who used medical services between October 2012 and September 2013 (n=32 617).Outcome measures(1) Use of LTUC, defined as urinary catheterisation for at least two consecutive months, to identify factors associated with LTUC and (2) the incidence of UTI, defined as a recorded diagnosis of UTI and prescription of antibiotics, in people with and without LTUC.ResultsThe 1-year prevalence of LTUC was 0.44% (143/32 617). Multivariable logistic regression analysis showed that the male sex, older age, higher comorbidity score, previous history of hospitalisation with in-hospital use of urinary catheters and high long-term care need level were independently associated with LTUC. The incidence rate of UTI was 33.8 and 4.7 per 100 person-years in people with and without LTUC, respectively. According to multivariable Poisson regression analysis, LTUC was independently associated with UTI (adjusted rate ratio 2.58, 95% CI 1.68 to 3.96). Propensity score-matched analysis yielded a similar result (rate ratio 2.41, 95% CI 1.45 to 4.00).ConclusionsWe identified several factors associated with LTUC in the community, and LTUC was independently associated with the incidence of UTI.

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Section: Discussionmentioning

confidence: 99%

Factors associated with long-term urinary catheterisation and its impact on urinary tract infection among older people in the community: a population-based observational study in a city in Japan

et al. 2019

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“…One of the main risk factors for bacteriuria and encrustation is the length of time a urinary catheter remains in situ; therefore, catheter changes are required to reduce the risk of blockages (Marcone Marchitti et al 2015b). Clinical guidelines do not recommend a 'one-size-fits-all' routine schedule for catheter changes, but rather recommend that the schedule should be based on the length of time that a urinary catheter remains functional for each patient (EAUN 2012, Murphy et al 2018. Therefore, the frequency of catheter changes will be dependent on each patient's needs; however, the catheter should not remain in situ beyond the manufacturer's recommended timeframe.…”

Section: Catheter Changesmentioning

confidence: 99%

“…The use of a catheter valve will allow the bladder to fill and flush and can remove the need for a drainage bag, which can improve patients' quality of life and is believed to reduce the risk of catheter blockages and CAUTIs; however, this claim is lacking in robust clinical evidence (Murphy et al 2018). The catheter valve may not be suitable for all patients and clinical assessment is required (Simpson 2017).…”

Section: Preventing Catheterassociated Urinary Tract Infectionsmentioning

confidence: 99%

“…For patients in community settings with a long-term urinary catheter in situ, the nurse will have a major role in providing the patient and/or their carer with education and support, assisting in the daily management of their catheter, and addressing any complications that may arise (Murphy et al 2018). Maeda et al (2017) identified that suboptimal catheter care by the patient or their carer is associated with increasingly frequent catheter blockages.…”

Section: Role Of the Nursementioning

confidence: 99%

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Prevention and management of urinary catheter blockages in community settings

et al. 2019

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Self-management of long-term urinary catheters can be challenging for patients, and recurrent catheter blockages may cause concern among patients, carers and healthcare professionals. Catheter blockages are a significant challenge for nurses practising in community settings, because frequent and unplanned catheter changes can be costly to healthcare services in terms of time and resources. This article details evidence-based recommendations for the assessment and diagnosis of catheter blockages, as well as the identification of risk factors. It also explains the interventions that can be used to prevent and manage catheter blockages and describes the role of the nurse in supporting patients with a long-term catheter in situ in community settings.

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“…This completely foreign object has little meaning, and adjusting life to living with one is often not easy, especially for older, frail or disabled patients (Prinjha et al, 2016;Prinjha & Chapple, 2013). Many patients have had repeat presentations to emergency departments with catheter-associated complications such as urinary tract infections, catheter blockages, urine leakage, which could potentially be avoided with support and guidance from clinicians and through the use of appropriate catheter self-care strategies (Murphy et al, 2018).…”

mentioning

confidence: 99%