Alternative Solutions to Urinary Catheterization
Catheter-associated urinary tract infection, or CAUTI, is a major challenge in healthcare facilities today. Although measures can be taken to reduce the chance of infection, the most effective way to reduce CAUTI is by not using a catheter at all.
Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009
The Centers for Disease Control and Prevention (CDC) recently released a new guideline for the prevention of catheter-associated urinary tract infections. “Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009”
Valid reasons for catheterization
The CDC guideline lists six valid clinical reasons when a patient should have a urinary catheter inserted. These are the only recommended indications for the use of a urinary catheter:
- Patient has acute urinary retention or bladder outlet obstruction
- Need for accurate measurements of urinary output in critically ill patients
- Perioperative use for selected surgical procedures:
- Patients undergoing urologic surgery or other surgery on contiguous structures of the genitourinary tract
- Anticipated prolonged duration of surgery (catheters inserted for this reason should be removed in PACU)
- Patients anticipated to receive large-volume infusions or diuretics during surgery
- Need for intraoperative monitoring of urinary output
- To assist in healing of open sacral or perineal wounds in incontinent patients
- Patient requires prolonged immobilization (e.g., potentially unstable thoracic or lumbar spine, multiple traumatic injuries such as pelvic fractures)
- To improve comfort for end of life care if needed
As you can see, merely being incontinent is not a valid clinical reason for urinary catheterization. So what is the alternative? Actually, there are several alternatives to help clinicians care for incontinent patients without having the use a urinary catheter:
The Centers for Medicare & Medicaid Services (CMS)
The Centers for Medicare & Medicaid Services (CMS) has published recommendations and regulations regarding incontinence and the prevention of catheter-associated urinary tract infections. Click below for a link to the CMS document that applies to your facility:
- Centers for Medicare & Medicaid Services – Long Term Care
- Centers for Medicare & Medicaid Services – Acute Care
