Care of patients with long-term indwelling urinary catheters.

The complications and management of long-term indwelling catheters used for urinary retention and incontinence were reviewed. Research evidence from 1992 - 2002 was located through searches of CINAHL (38 articles), and Medline (89 articles). Fifty studies were critiqued for this review. The most com...

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Publicado en:Online Journal of Issues in Nursing Vol. 8; no. 3; pp. 10p - 11
Autores principales: Madigan E, Neff DF
Formato: research systematic review tables/charts Journal Article
Publicado: American Nurses Association 2003
Acceso en línea:Ver este registro en EBSCOhost
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      pub: American Nurses Association
      place: Silver Spring, Maryland
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        atl: Care of patients with long-term indwelling urinary catheters.
      aug:
        au:
          Madigan E
          Neff DF
        affil: The Sarah Cole Hirsh Institute for Best Nursing Practices, Case Western Reserve University Frances Payne Bolton School of Nursing
      sug:
        subj:
          Catheter Care, Urinary
          Catheter-Related Complications
          Bacteriuria
          Catheter Irrigation, Urinary
          Catheter Occlusion
          Catheter Removal
          Catheter-Related Complications Prevention and Control
          Catheter-Related Infections
          Catheters, Urinary
          Inpatients
          Long Term Care
          Nursing Practice, Evidence-Based
          Outpatients
          Time Factors
          Urinary Tract Infections
          Human
      ab: The complications and management of long-term indwelling catheters used for urinary retention and incontinence were reviewed. Research evidence from 1992 - 2002 was located through searches of CINAHL (38 articles), and Medline (89 articles). Fifty studies were critiqued for this review. The most common complications of long-term indwelling catheters are bacteriuria, encrustation, and blockage. Less common is the prevalence of bacteremia and renal disease. Risk factors for bacteriuria include female gender, older age, and long-term indwelling catheter use. Urinary white blood cells are the best indicator of urinary tract infection. For drainable catheter systems used by community dwelling adults, daily bag cleaning with a diluted bleach solution (1:10) is effective in reducing bacterial counts to negligible numbers. Application of topical antibiotic cream to the meatus around the catheter does not reduce bacteriuria. Silicone catheters and larger lumen size catheters are more resistant to encrustation than other catheter types and smaller lumen size catheters. Acidifying the urine without removing the urease-producing bacteria does not reduce encrustation. Removal of catheter blockage is preventive for renal disease. Because of the complications of long-term indwelling catheter usage, periodic assessment and voiding trials should be used to determine the continued need for a catheter. Evidence-based recommendations for managing indwelling urinary catheters include screening for risk factors and evaluating urinary white blood cell count for infection, and assessment of the continued need for a catheter. Interventions include consideration of closed versus open drainage systems, type of catheter, and size of catheter lumen. © 2003 Online Journal of Issues in Nursing June 30, 2003
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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