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Question 5#

Which indication below is NOT an appropriate indication for indwelling bladder catheterization in the ICU?

A. Management of urinary incontinence
B. Management of immobilized patients
C. Management of patients with neurogenic bladder
D. Hourly urine output measurement in critically ill patients

Correct Answer is A

Comment:

Correct Answer: A

Unwarranted urinary catheter placement is very common, occurring in approximately 20% to 50% of hospitalized patients. Urinary catheters should not be placed for the management of urinary incontinence alone (Answer A). Answers B, C, and D represent appropriate indications for catheter placement. Other appropriate indications include management of urinary retention, hematuria associated with clots, open wounds of the sacrum or perineum with associated urinary incontinence, surgery of the genitourinary tract and associated structures, end-of-life care, and occasionally for management of patients with persistent urinary incontinence after conservative, behavioral, pharmacologic, and surgical measures have failed. Regardless of the indication for catheter placement, catheters should be removed as soon as the condition leading to the indication for catheterization has resolved. 

References:

  1. Meddings J, Saint S, Fowler KE, et al. The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA appropriateness method. Ann Intern Med. 2015;162(9 suppl):S1-S34.
  2. Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA; Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol. 2010;31(4):319.