Don’t place or leave in place urinary catheters for unacceptable indications
Urinary tract infection (UTI) has long been considered the most common healthcare-associated infection. They account for increased morbidity and mortality, excess length of hospital stay, increased cost and unnecessary antimicrobial use. Avoiding unnecessary urinary catheter use is the most important strategy in prevention of Catheter-associated Urinary Tract Infection (CAUTI) Appropriate indications for indwelling urinary catheter placement in medical patients include acute retention or outlet obstruction, continuous bladder irrigation for gross hematuria, need for accurate measurements of urinary output in critically ill patients, assisting in healing of deep sacral or perineal wounds in female patients with urinary incontinence and providing comfort at the end of life. Without critical illness use weights instead of urinary catheters to monitor diuresis. Incontinence, immobilization or dementia are not proper indications for urinary catheter use.
1. Canadian Society of Internal Medicine, Choosing Wisely Canada recommendation 2.
2. Society of Hospital Medicine- Adult of Hospital Medicine, Choosing Wisely recommendation 1 (2013)
3. American Academy of Nursing, Choosing Wisely recommendation 5 (2014)
4. The society for post acute and long–term care (AMDA), Choosing Wisely recommendation 6
6. Meddings J, Rogers MA, Krein SL, Fakih MG, Olmsted RN, Saint S. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf 2014; 23: 277-89.
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.