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Urinary Catheter Indications in the United States: Results from a National Survey of Acute Care Hospitals

  • M. Todd Greene (a1) (a2), Hiroko Kiyoshi-Teo (a3), Heidi Reichert (a1) (a2), Sarah Krein (a1) (a2) (a4) and Sanjay Saint (a1) (a2) (a4)...
Extract

In a survey of acute care hospitals across the United States, we found that many hospitals use indwelling urinary catheters for reasons that are not medically necessary (eg, urinary incontinence without outlet obstruction and patient/family requests). Our findings highlight an opportunity to reduce unnecessary catheter use through promoting awareness of appropriate use.

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Copyright
Corresponding author
a. Address correspondence to M. Todd Greene, PhD, MPH, University of Michigan Medical School, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109-2800 ( mtgreene@med.umich.edu ).
References
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1. Gokula, RR, Hickner, JA, Smith, MA. Inappropriate use of urinary catheters in elderly patients at a midwestern community teaching hospital. Am J Infect Control 2004;32(4):196199.
2. Gould, CV, Umscheid, CA, Agarwal, RK, Kuntz, G, Pegues, DA; Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol 2010;31(4):319326.
3. Gardam, MA, Amihod, B, Orenstein, P, Consolacion, N, Miller, MA. Overutilization of indwelling urinary catheters and the development of nosocomial urinary tract infections. Clin Perform Qual Health Care 1998;6(3):99102.
4. Jain, P, Parada, JP, David, A, Smith, LG. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Arch Intern Med 1995;155(13):14251429.
5. Munasinghe, RL, Yazdani, H, Siddique, M, Hafeez, W. Appropriateness of use of indwelling urinary catheters in patients admitted to the medical service. Infect Control Hosp Epidemiol 2001;22(10):647649.
6. Hollingsworth, JM, Rogers, MA, Krein, SL, et al. Determining the noninfectious complications of indwelling urethral catheters: a systematic review and meta-analysis. Ann Intern Med 2013; 159(6):401410.
7. Saint, S, Kowalski, CP, Kaufman, SR, et al. Preventing hospital-acquired urinary tract infection in the United States: a national study. Clin Infect Dis 2008;46(2):243250.
8. Krein, SL, Hofer, TP, Kowalski, CP, et al. Use of central venous catheter-related bloodstream infection prevention practices by US hospitals. Mayo Clin Proc 2007;82(6):672678.
9. Fakih, MG, George, C, Edson, BS, Goeschel, CA, Saint, S. Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies. Infect Control Hosp Epidemiol 2013;34(10):10481054.
10. Greene, MT, Fakih, MG, Fowler, K, et al. Regional variation in urinary catheter use and catheter-associated urinary tract infection: results from a national collaborative. Infect Control Hosp Epidemiol 2014;35(suppl 3):S99S106 (in this issue).
11. Markland, AD, Richter, HE, Fwu, CW, Eggers, P, Kusek, JW. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol 2011;186(2):589593.
12. Krein, SL, Kowalski, CP, Harrod, M, Forman, J, Saint, S. Barriers to reducing urinary catheter use: a qualitative assessment of a statewide initiative. JAMA Intern Med 2013:16.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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