The use of indwelling urinary catheters among hospital patients is common. Yet it can also lead to preventable harms such as urinary tract infection, sepsis and delirium. Guidelines support routine assessment of appropriate urinary catheter indications —including acute urinary obstruction, critical illness and end-of-life care—and minimizing their duration of use. Strategies consistent with CAUTI (catheter-associated urinary tract infection) guidelines regarding inappropriate urinary catheter use have been shown to reduce health care-associated infections.

Conditions: CAUTI (catheter-associated urinary tract infection), sepsis, delirium

Procedures: Indwelling urinary catheter, Foley Catheter

Sources

• Association for Professionals in Infection Control and Epidemiology. APIC implementation guide: guide to preventing catheter-associated urinary tract infections [Internet]. 2014 Apr [cited 2016 Oct 14]. (APIC PDF)
• Canadian Society of Hospital Medicine. Five things physicians and patients should question [Internet]. 2015 Jun 2 [cited 2016 Oct 21]. (Choosing Wisely)
• Colli J, Tojuola B, Patterson AL, et al. National trends in hospitalization from indwelling urinary catheter complications, 2001-2010. Int Urol Nephrol. 2014 Feb;46(2):303-8. (PubMed)
• Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010 Mar 1;50(5):625-63. (PubMed)
• Jain P, Parada JP, David A, et al. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Arch Intern Med. 1995 Jul 10;155(13):1425-9.(PubMed)
• Krein SL, Kowalski CP, Harrod, M, et al. Barriers to reducing urinary catheter use: a qualitative assessment of a statewide initiative. JAMA Intern Med. 2013 May 27;173(10):881-6. (PubMed)
• Landrigan CP, Parry GJ, Bones CB, et al. Temporal trends in rates of patient harm resulting from medical care. N Engl J Med. 2010 Nov 25;363(22):2124-34. (PubMed)
• Lo E, Nicolle LE, Coffin SE, et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014 Sep;35 Suppl 2:S32-47. (PubMed)
• Miller BL, Krein SL, Fowler KE, et al. A multimodal intervention to reduce urinary catheter use and associated infection at a Veterans Affairs Medical Center. Infect Control Hosp Epidemiol. 2013 Jun;34(6):631-3. (PubMed)
• O’Mahony R, Murthy L, Akunne A, et al. Synopsis of the National Institute for Health and Clinical Excellence guideline for prevention of delirium. Ann Intern Med. 2011 Jun 7;154(11):746-51. (PubMed)
• Ramanathan R, Duane TM. Urinary tract infections in surgical patients. Surg Clin North Am. 2014 Dec;94(6):1351-68. (PubMed)