Critical Care Medicine-Infections and Immunologic Disease>>>>>Hospital Infection Control, Hospital Acquired Infections
Question 4#

Which of the following scenarios represents INAPPROPRIATE use of an indwelling urethral catheter?

A. Monitoring urine output in a man with urinary incontinence
B. Monitoring urine output in a man with urinary incontinence and urinary retention
C. Obtaining urine for testing in a patient who can void spontaneously
D. All of the above are inappropriate uses of an indwelling urethral catheter

Correct Answer is D

Comment:

Correct Answer: D

Up to half of all indwelling urethral catheters in hospitalized patients are placed for inappropriate indications. Patients who can void spontaneously or collect urine for testing do no need an invasive urethral catheter placed. Men with urinary incontinence without obstruction can have an external penile sheath (“Texas” or “condom” style) catheter placed. Intermittent urethral catheterization can be used for patients with urinary retention or obstruction and must be performed at regular intervals to prevent bladder overdistention. 

References:

  1. Lo E, Nicolle LE, Coffin SE, et al. Strategies to prevent catheterassociated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35:464-479.
  2. Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010;50:625-663.