Securing the indwelling catheter

Department of Urology, University of Virginia, Charlottesville, VA, USA.
The American journal of nursing (Impact Factor: 1.32). 01/2009; 108(12):44-50; quiz 50. DOI: 10.1097/01.NAJ.0000342069.15536.b5
Source: PubMed

ABSTRACT Each year, millions of Americans are catheterized to ensure adequate bladder drainage. But despite the high rate of catheterization in acute care facilities, clinicians often pay little attention to the decision to insert an indwelling catheter, its optimal management, or especially its timely removal. A physician or NP typically orders the insertion of a urinary catheter, but a nurse often performs the catheterization and is responsible for its management. Reimbursement policy changes recently mandated by the Centers for Medicare and Medicaid Services-including one stipulating that Medicare will no longer cover the cost of treating catheter-associated urinary tract infections-have resulted in increased scrutiny of indwelling catheter management. This article explores one aspect of catheter management, the use of securement devices, and analyzes the standard practices, expert opinion, and clinical evidence concerning this intervention.

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    • "The proper management of an indwelling urinary catheter is one of the most common problems faced by patients and health professionals, both in hospital and primary health care settings, and a number of studies have reported on the problems relating to the management of an indwelling catheter (Tenke et al., 2008; Tsuchida et al., 2008; Gallegos, 2009; Parker et al., 2009a, 2009b). The role of the nurse has been suggested as being key to the assessment of appropriateness of continuing indwelling urinary catheter use and to the timely implementation of practices aimed at the identification and prevention of complications associated with this method of urinary drainage (Marklew, 2004; Gray, 2008). While perhaps a truism, it is nonetheless essential that to ensure a standard of care that is high and consistent nurses must have appropriate levels of knowledge and skills as nursing interventions to help prevent complications are required during each phase of nursing care. "
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    Journal of wound, ostomy, and continence nursing: official publication of The Wound, Ostomy and Continence Nurses Society / WOCN 38(5):581-3. DOI:10.1097/WON.0b013e31822b3280 · 1.00 Impact Factor
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    ABSTRACT: Changes in reimbursement policies have focused attention on the use of indwelling catheters in the critical care unit as well as their role in hospital-acquired urinary tract infections. Implementation of an evidence-based prevention program can significantly reduce both the prevalence of indwelling catheterization and the incidence of hospital-acquired catheter-associated urinary tract infection. This article describes the epidemiology and pathophysiology of catheter-associated urinary tract infection, and outlines essential elements of an evidence-based prevention program for the critical care unit.
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