Indwelling Urinary Catheters: A One-Point Restraint? (2002)

Editorials16 July 2002Indwelling Urinary Catheters: A One-Point Restraint?Sanjay Saint, MD, MPH, Benjamin A. Lipsky, MD, and Susan Dorr Goold, MD, MHSA, MASanjay Saint, MD, MPH, Benjamin A. Lipsky, MD, and Susan Dorr Goold, MD, MHSA, MAAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-2-200207160-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail More than four decades ago, Dr. Paul Beeson persuasively argued against routine use of indwelling urinary catheters in hospitalized patients, making the "case against the catheter" (1). He urged, "The decision to use this instrument should be made with the knowledge that it involves risk of producing a serious disease" (1). This advice remains relevant today. Although these devices provide indispensable benefits, they are also the dominant risk factor for hospital-acquired urinary tract infection, the most common nosocomial infection in the United States (2). Infections and other untoward effects associated with indwelling urinary catheters lead to increased health care costs, ...References1. Beeson PB. The case against the catheter. Am J Med. 1958;24:1-3. CrossrefMedlineGoogle Scholar2. Haley RW, Culver DH, White JW, Morgan WM, Emori TG. The nationwide nosocomial infection rate. A new need for vital statistics. Am J Epidemiol. 1985;121:159-67. [PMID: 4014113] CrossrefMedlineGoogle Scholar3. Saint S. Clinical and economic consequences of nosocomial catheter-related bacteriuria. Am J Infect Control. 2000;28:68-75. [PMID: 10679141] CrossrefMedlineGoogle Scholar4. Saint S, Lipsky BA, Baker PD, McDonald LL, Ossenkop K. Urinary catheters: what type do men and their nurses prefer? J Am Geriatr Soc. 1999;47:1453-7. [PMID: 10591242] CrossrefMedlineGoogle Scholar5. Platt R, Polk BF, Murdock B, Rosner B. Mortality associated with nosocomial urinary-tract infection. N Engl J Med. 1982;307:637-42. [PMID: 7110215] CrossrefMedlineGoogle Scholar6. Platt R, Polk BF, Murdock B, Rosner B. Reduction of mortality associated with nosocomial urinary tract infection. Lancet. 1983;1:893-7. [PMID: 6132220] CrossrefMedlineGoogle Scholar7. Jain P, Parada JP, David A, Smith LG. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Arch Intern Med. 1995;155:1425-9. [PMID: 7794092] CrossrefMedlineGoogle Scholar8. Hartstein AI, Garber SB, Ward TT, Jones SR, Morthland VH. Nosocomial urinary tract infection: a prospective evaluation of 108 catheterized patients. Infect Control. 1981;2:380-6. [PMID: 6795141] CrossrefMedlineGoogle Scholar9. Saint S, Wiese J, Amory JK, Bernstein ML, Patel UD, Zemencuk JK, et al . Are physicians aware of which of their patients have indwelling urinary catheters? Am J Med. 2000;109:476-80. [PMID: 11042237] CrossrefMedlineGoogle Scholar10. Weinstein JW, Mazon D, Pantelick E, Reagan-Cirincione P, Dembry LM, Hierholzer WJ. A decade of prevalence surveys in a tertiary-care center: trends in nosocomial infection rates, device utilization, and patient acuity. Infect Control Hosp Epidemiol. 1999;20:543-8. [PMID: 10466554] CrossrefMedlineGoogle Scholar11. Wong ES. Guideline for prevention of catheter-associated urinary tract infections. Am J Infect Control. 1983;11:28-36. [PMID: 6551151] CrossrefMedlineGoogle Scholar12. Saint S, Lipsky BA. Preventing catheter-related bacteriuria: Should we? Can we? How? Arch Intern Med. 1999;159:800-8. [PMID: 10219925] CrossrefMedlineGoogle Scholar13. Haley RW, Hooton TM, Culver DH, Stanley RC, Emori TG, Hardison CD, et al . Nosocomial infections in U.S. hospitals, 1975-1976: estimated frequency by selected characteristics of patients. Am J Med. 1981;70:947-59. [PMID: 6938129] CrossrefMedlineGoogle Scholar14. Tambyah PA, Maki DG. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1,497 catheterized patients. Arch Intern Med. 2000;160:678-82. [PMID: 10724054] MedlineGoogle Scholar15. Minnick AF, Mion LC, Leipzig R, Lamb K, Palmer RM. Prevalence and patterns of physical restraint use in the acute care setting. J Nurs Adm. 1998;28:19-24. [PMID: 9824980] CrossrefMedlineGoogle Scholar16. Marks W. Physical restraints in the practice of medicine. Current concepts. Arch Intern Med. 1992;152:2203-6. [PMID: 1444679] CrossrefMedlineGoogle Scholar17. Macpherson DS, Lofgren RP, Granieri R, Myllenbeck S. Deciding to restrain medical patients. J Am Geriatr Soc. 1990;38:516-20. [PMID: 2332572] CrossrefMedlineGoogle Scholar18. Mion LC, Frengley JD, Jakovcic CA, Marino JA. A further exploration of the use of physical restraints in hospitalized patients. J Am Geriatr Soc. 1989;37:949-56. [PMID: 2624628] CrossrefMedlineGoogle Scholar19. Lofgren RP, MacPherson DS, Granieri R, Myllenbeck S, Sprafka JM. Mechanical restraints on the medical wards: are protective devices safe? Am J Public Health. 1989;79:735-8. [PMID: 2729470] CrossrefMedlineGoogle Scholar20. Miles SH, Irvine P. Deaths caused by physical restraints. Gerontologist. 1992;32:762-6. [PMID: 1478494] CrossrefMedlineGoogle Scholar21. . Medicare and Medicaid programs: hospital conditions of participation, patient rights. Health Care Financing Administration, Department of Health and Human Services. Fed Regist. 1999;64:36070-89. Google Scholar Author, Article, and Disclosure InformationAffiliations: Disclaimer: Dr. Saint has received an honorarium from C.R. Bard, Inc., and serves as a consultant to UroSolutions, Inc.Grant Support: Dr. Saint is supported by a Career Development Award from the Veterans Affairs Health Services Research & Development Program. Dr. Goold is supported by a Robert Wood Johnson Generalist Physician Faculty Award.Corresponding Author: Sanjay Saint, MD, MPH, Patient Safety Enhancement Program, University of Michigan Health System, Room 7E08, 300 NIB–Campus Box 0429, Ann Arbor, MI 48109-0429; e-mail, [email protected]edu.Current Author Addresses: Dr. Saint: University of Michigan Health System, Division of General Medicine, Room 7E08, 300 NIB, Campus Box 0429, Ann Arbor, MI 48109-0429.Dr. Lipsky: VA Puget Sound Healthcare System, General Internal Medicine Clinic (S-111-GIMC), 1660 South Columbian Way, Seattle, WA 98108.Dr. Goold: University of Michigan Health System, Division of General Medicine, Room 7B19, 300 NIB, Campus Box 0429, Ann Arbor, MI 48109-0429. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUrinary Catheters: A One-Point Restraint? Rajika L. Munasinghe , Vijayalakshmi Nagappan , and Mohamed Siddique Urinary Catheters: A One-Point Restraint? Sanjay Saint , Benjamin A. 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Munasinghe, MD, Vijayalakshmi Nagappan, MD, and Mohamed Siddique, MDSafety of Urinary CathetersSafety of Urinary Catheters—ReplyIndwelling Urinary CathetersCatheter Care 16 July 2002Volume 137, Issue 2Page: 125-127KeywordsBladderCatheter-related infectionsCatheterizationCathetersHealth carePressure ulcersPublic policySafetyUrinary tract infections ePublished: 16 July 2002 Issue Published: 16 July 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...