JAMDA
Volume 3, Issue 3 , Pages 162-168 , May 2002

Use and Management of Chronic Urinary Catheters in Long-Term Care: Much Controversy, Little Consensus

  • Julie K. Gammack, MD

      Affiliations

    • Corresponding Author InformationAddress correspondence to: Julie K. Gammack, MD, Baylor College of Medicine, Huffington Center on Aging, One Baylor Plaza, M320, Houston, TX 77030

References 

  1. Jain P, Parada JP, David A, Smith LG. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Arch Intern Med. 1994;155:1425–1429
  2. Warren JW, Damron D, Tenney JH, et al. Fever, bacteremia, and death as complications of bacteriuria in women with long-term urethral catheters. J Infect Dis. 1987;155:1151–1158
  3. Kaufman JM, Fam B, Jacobs SC, et al. Bladder cancer and squamous metaplasia in spinal cord injury patients. J Urol. 1977;118:967–971
  4. Ouslander JG, Greengold B, Chen S. Complications of chronic indwelling urinary catheters among male nursing home patients: A prospective study. J Urol. 1987;138:1191–1195
  5. Warren JL, Steinberg R, Hebel JR, Tenney JH. The prevalence of urethral catheterization in Maryland nursing homes. Arch Intern Med. 1989;149:1535–1537
  6. Kunin CM, Douthitt S, Dancing J, et al. The association between the use of urinary catheters and morbidity and mortality among elderly patients in nursing homes. Am J Epidemiol. 1992;135:291–301
  7. Harrington C, Carrillo H. Thollaug SC, et al. Nursing Facilities, Staffing, Residents, and Facility Deficiencies, through 1998. Department of Behavior and Social Sciences, University of California San Francisco Web site. January 2000. Available at: http://www.resdac.umn.edu/pdf/nursfa98.pdf. Accessed August 23, 2001.
  8. Hebel JR, Warren JW. The use of urethral, condom, and suprapubic catheters in aged nursing home patients. J Am Geriatr Soc. 1990;38:777–784
  9. Zimakoff JD, Pontoppidan B, Larsen SO, et al. The management of urinary catheters: Compliance of practice in Danish hospitals, nursing homes and home care to national guidelines. Scand J Urol Nephrol. 1995;29:299
  10. Fitzgerald MP, Kulkarni N, Fenner D. Postoperative resolution of urinary retention in patients with advanced pelvic organ prolapse. Am J Obstet Gynecol. 2000;183:1361–1363
  11. Coates KW, Harris RL, Cundiff GW, Bump RC. Uroflowmetry in Women with Urinary Incontinence and Pelvic Organ Prolapse. Br J Urol. 1997;80:217–221
  12. Hastie KJ, Dickinson AJ, Ahmad R, Moisey CU. Acute retention of urine: Is trial without catheter justified?. J R Coll Surg Edinb. 1990;35:225–227
  13. Djavan B, Shariat S, Omar M, et al. Does prolonged catheter drainage improve the chance of recovering voluntary voiding after acute retention of urine (AUR)?. Eur Urol. 1998;33(suppl):110
  14. Murray K, Massey A, Feneley RCL. Acute urinary retention: A urodynamic assessment. Br J Urol. 1984;56:468–473
  15. Klarskov P, Andersen JT, Asmussen CF, et al. Symptoms and signs predictive of the voiding pattern after acute urinary retention in men. Scand J Urol Nephrol. 1987;21:23–28
  16. Ouslander JG, Palmer MH, Rovner BW, German PS. Urinary incontinence in nursing homes: Incidence, remission and associated factors. J Am Geriatr Soc. 1993;41:1083–1089
  17. Urinary Incontinence Guideline Panel. Urinary Incontinence in Adults: Clinical Practice Guideline, AHCPR Pub. No. 96–0682. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Department of Heath and Human Services, 1996.
  18. Ouslander JG, Schnelle JF, Uman G, et al. Does oxybutynin add to the effectiveness of prompted voiding for urinary incontinence among nursing home residents? A placebo-controlled trial. J Am Geriatr Soc. 1995;43:610–617
  19. Ouslander JG, Greendale GA, Uman G, et al. Effects of oral estrogen and progestin on the lower urinary tract among female nursing home residents. J Am Geriatr Soc. 2001;29:303–307
  20. Ouslander JG, Osterweil D, Morley J. Medical Care in the Nursing Home. 2nd Ed.. New York: McGraw-Hill; 1997;
  21. Hu T-W, Igou JF, Kaltreider DL, et al. A clinical trial of a behavioral therapy to reduce urinary incontinence in nursing homes. JAMA. 1989;261:2656–2662
  22. Colling J, Ouslander J, Hadley BJ, et al. The effects of patterned urge-response toileting (PURT) on urinary incontinence among nursing home residents. J Am Geriatr Soc. 1992;39:135–141
  23. Ouslander JG, Schnelle JF, Uman G, et al. Predictors of successful prompted voiding among incontinence nursing home residents. JAMA. 1995;273:1366–1370
  24. Ribeiro BJ, Smith SR. Evaluation of urinary catheterization and urinary incontinence in a general nursing home population. J Am Geriatr Soc. 1985;33:479–482
  25. Armstrong EP, Ferguson TA. Urinary incontinence: Healthcare resource consumption in veterans affairs medical centers. Veterans Health Syst J. 1998;37–42
  26. Saint S, Lipsky BA, Baker PD, et al. Urinary catheters: What type do men and their nurses prefer?. J Am Geriatr Soc. 1999;47:1453–1457
  27. Johnson TM, Ouslander JG, Uman GC, Schnelle JF. Urinary incontinence treatment preferences in long-term care. J Am Geriatr Soc. 2001;49:710–718
  28. McMurdo ME, Davey PG, Elder MA, et al. A cost-effectiveness study of the management of intractable urinary incontinence by urinary catheterization or incontinence pads. J Epidemiol Community Health. 1992;46:222–226
  29. Smith DM. Pressure ulcers in the nursing home. Ann Intern Med. 1995;123:433–442
  30. Michocki RJ, Lamy PP. The problem of pressure sores in a nursing home population: Statistical data. J Am Geriatr Soc. 1976;24:323–328
  31. Maklebust J, Magnan MA. Risk factors associated with having a pressure ulcer: A secondary data analysis. Adv Wound Care. 2000;7:25–42
  32. Andersen KE, Kvorning SA. Medical aspects of the decubitus ulcer. Int J Dermatol. 1982;21:265–270
  33. Brandeis GH, Ooi WL, Hossain M, et al. A longitudinal study of risk factors associated with the formation of pressure ulcers in nursing homes. J Am Geriatr Soc. 1994;42:388–393
  34. Bergstrom N, Braden B. A prospective study of pressure sore risk among institutionalized elderly. J Am Geriatr Soc. 1992;40:747–758
  35. Berlowitz DR, Wilking SV. Risk factors for pressure sores. J Am Geriatr Soc. 1989;37:1043–1050
  36. Allman RM, Laprade CA, Noel LB, et al. Pressure sores among hospitalized patients. Ann Intern Med. 1986;105:337–342
  37. Nicolle LE, Orr P, Duckworth H, et al. Prospective study of decubitus ulcers in two long term care facilities. Can J Infect Control. 1994;9:35–38
  38. Treatment of Pressure Ulcers Guideline Panel. Treatment of Pressure Ulcers. Clinical Practice Guideline Number 15. AHCPR Pub No. 95–0652. Rockville, MD: Agency for Health Care Policy and Research, US Department of Heath and Human Services, Public Heath Service, 1994.
  39. Johnson ET. The condom catheter: Urinary tract infection and other complications. South Med J. 1983;76:579–582
  40. Jayachandran S, Mooppan UM, Kim H. Complications from external (condom) urinary drainage devices. Urology. 1985;25:31–34
  41. Nanninga JB, Rosen J. Problems associated with the use of external urinary collectors in the male paraplegic. Paraplegia. 1975;13:56
  42. Fierer J, Elkstrom M. An outbreak of Providencia stuartii urinary tract infections. JAMA. 1981;245:1553–1555
  43. Hirsh DD, Fainstein V, Musher DM. Do condom catheter collecting systems cause urinary tract infections?. JAMA. 1979;242:340–341
  44. Ouslander JG, Greengold B, Chen S. External catheter use and urinary tract infections among incontinent male nursing home patients. J Am Geriatr Soc. 1987;35:1063–1070
  45. Zimakoff J, Stickler DJ, Pontoppidan B, Larsen SO. Bladder Management and urinary tract infections in Danish hospitals, nursing homes, and home care: A National Prevalence Study. Infect Control Hosp Epidemiol. 1996;17:215–221
  46. Saint S, Lipsky BA. Preventing catheter-related bacteriuria: Should we?. Can we? How? Arch Intern Med. 1999;159:800–808
  47. O'Kelly TJ, Mathew A, Ross S, Munro A. Optimum method for urinary drainage in major abdominal surgery: A prospective randomized trail of suprapubic versus urethral catheterization. Br J Surg. 1995;82:1367–1368
  48. Shapiro J, Hoffmann J, Jersky J. A comparison of suprapubic and transurethral drainage for postoperative urinary retention in general surgical patients. Acta Chir Scand. 1982;148:323–327
  49. Andersen JT, Heisterberg L, Hebjorn S, et al. Suprapubic versus transurethral bladder drainage after colposuspension/vaginal repair. Acta Obstet Gynecol Scand. 1985;64:139–143
  50. Mitsui T, Minami K, Furuno T, et al. Is suprapubic cystostomy an optimal urinary management in high quadriplegics? A comparative study of suprapubic cystostomy and clean intermittent catheterization. Eur Urol. 2000;38:434–438
  51. Horgan AF, Prasad B, Waldron DJ, O'Sullivan DC. Acute urinary retention: Comparison of suprapubic and urethral catheterization. Br J Urol. 1992;70:149–151
  52. Duffy LM, Cleary J, Ahern S, et al. Clean intermittent catheterization: Safe, cost-effective bladder management for male residents of VA nursing homes. J Am Geriatr Soc. 1995;43:865–870
  53. Moore KN, Kelm M, Sinclair O, Cadrain G. Bacteriuria in intermittent catheterization users: The effect of sterile versus clean reused catheters. Rehabil Nurs. 1993;18:306–309
  54. Sadowski AJ, Duffy LM. A survey of clean intermittent catheterization in long-term care. Urol Nurs. 1988;9:15–17
  55. Warren JW. Catheter-associated urinary tract infections. Infect Dis Clin North Am. 1997;11:609–622
  56. Wyndaele J-J, Maes D. Clean intermittent self-catheterization: A 12-year follow-up. J Urol. 1990;143:906–908
  57. Tangtrakul S, Taechaiya S, Suthutvoravut S, Lindsmita V. Post-cesarean section urinary tract infection: A comparison between intermittent and indwelling catheterization. J Med Assoc Thai. 1994;77:244–248
  58. Skelly JM, Guyatt GH, Kalbfleisch R, et al. Management of urinary retention after surgical repair of hip fracture. CMAJ. 1992;146:1185–1189
  59. Dobbs SP, Jackson SR, Wilson AM, et al. A Prospective, randomized trial comparing continuous bladder drainage with catheterization at abdominal hysterectomy. Br J Urol. 1997;80:554–556
  60. Kunin CM, McCormack RC. Prevention of catheter-induced urinary-tract infections by sterile closed drainage. N Engl J Med. 1966;274:1155–1161
  61. Dille C, Kirchhoff K, Sullivan J, Larson E. Increasing the wear time of vinyl urinary drainage bags by decontamination with bleach. Arch Phys Med Rehabil. 1992;74:431–437
  62. Burgener S. Justification of closed intermittent urinary catheter irrigation/instillation: A review of current research and practice. J Adv Nurs. 1987;12:229–234
  63. Rao GG, Elliott TSJ. Bladder Irrigation. Age Ageing. 1988;17:373–378
  64. Dudley M, Barriere S. Antimicrobial irrigations in the prevention and treatment of catheter-related urinary tract infections. Am J Hosp Pharm. 1981;38:59–65
  65. Rew M. Use of catheter maintenance solutions for long-term catheters. Br J Nurs. 1999;8:708–715
  66. Anderman S, Jaschevatzky DE, Ellenbogen A, Frunstein S. Urinary tract infection after bladder irrigation with povidone-iodine in vaginal surgery. Lancet. 1986;2:294
  67. Warren JW, Platt R, Thomas RJ, et al. Antibiotic irrigation and catheter-associated urinary-tract infection. N Engl J Med. 1978;299:570–573
  68. Wong E, Hooton T. Guideline for prevention of catheter-associated urinary tract infection. Infect Control. 1981;2:125–130
  69. Burke JP, Garibaldi RA, Britt MR, et al. Prevention of catheter-associated urinary tract infections. Am J Med. 1981;70:655–658
  70. Burke JP, Jacobson JA, Garibaldi RA, et al. Evaluation of daily meatal care with poly-antibiotic ointment in prevention of urinary catheter-associated bacteriuria. J Urol. 1983;129:331–334
  71. Kunin C, Chin QF, Chambers S. Indwelling urinary catheters in the elderly. Am J Med. 1987;82:405–411
  72. Priefer BA, Duthie EH, Gambert SR. Frequency of urinary catheter change and clinical urinary tract infection. Urology. 1982;20:141–142
  73. Raz R, Schiller D, Nicolle LE. Chronic indwelling catheter replacement before antimicrobial therapy for symptomatic urinary tract infection. J Urol. 2000;164:1254–1258
  74. Saint S, Elmore JG, Sullivan SD, et al. The efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: A meta-analysis. Am J Med. 1998;105:236–241
  75. Saint S. Prevention of nosocomial urinary tract infections, chapter 15. In: Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Agency for Healthcare Research and Quality Web site. Available at: www:ahcpr.gov/clinic/ptsafety/chap15a.htm#15.1. Accessed September 13, 2001.
  76. Warren JW, Tenney JH, Hoopes JM, et al. A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. J Infect Dis. 1982;146:719–723
  77. Breitenbucher R. Bacterial changes in the urine samples of patients with long-term indwelling catheters. Arch Intern Med. 1984;144:1585–1588
  78. Garibaldi RA, Mooney BR, Epstein BJ, Britt MR. An evaluation of daily bacteriologic monitoring to identify preventable episodes of catheter-associated urinary tract infection. Infect Control. 1982;3:466–470
  79. Warren JW, Anthony WC, Hoopes JM, Muncie HL. Cephalexin for susceptible bacteriuria in afebrile, long-term catheterized patients. JAMA. 1982;248:454–458
  80. Mountokalakis T, Skounakis M, Tselentis J. Short-term versus prolonged systemic antibiotic prophylaxis in patients treated with indwelling catheters. J Urol. 1985;134:506–508
  81. Orr PH, Nicolle LE, Duckworth H, et al. Febrile urinary infection in the institutionalized elderly. Am J Med. 1996;100:71–77
  82. Tambyah PA, Maki DG. The relationship between pyuria and infection in patients with indwelling urinary catheters. Arch Intern Med. 2000;160:673–677
  83. McCue JD. Complicated UTI: Effective treatment in the long-term care setting. Geriatrics. 2000;55:51–61
  84. McGeer A, Campbell B, Emori TG, et al. Definition of infection for surveillance in long-term care facilities. Am J Infect Control. 1991;19:1–7
  85. Nicolle LE, Smith P, Thrupp L, et al. Urinary tract infections in long-term-care facilities. Infect Control Hosp Epidemiol. 2001;22:167–175
  86. Loeb M, Bentley DW, Bradley S, et al. Development of minimum criteria for the initiation of antibiotics in residents of long-term-care facilities: results of a consensus conference. Infect Control Hosp Epidemiol. 2001;22:120–124
  87. Beier MT. Management of urinary tract infections in the nursing home elderly: a proposed algorithmic approach. Int J Antimicrob Agents. 1999;11:275–284

PII: S1525-8610(04)70459-4

doi: 10.1016/S1525-8610(04)70459-4

JAMDA
Volume 3, Issue 3 , Pages 162-168 , May 2002

Article Tools