Forgetful Doctors Means Catheter Misuse

B O S T O N, Oct. 13 -- Are doctors and nurses more concerned with their work relief than your bladder relief?

In a small study of four medical centers, published in the current issue of the American Journal of Medicine, researchers found that 31 percent of hospitalized patients who receive urinary catheters don’t need them.

Why the over-catheterization? Catheters make it easier for nursing staff not to clean up a soiled sheet, say, of an elderly patient who may or may not be able to control his or her bladder. Once inserted, the devices often remain too long because doctors either forget or don’t know they are there.

Concern Over Catheters Prolonged catheter use is a concern because the practice can lead to painful urinary tract infections and longer hospital stays, says Dr. Sanjay Saint, assistant professor of internal medicine at the University of Michigan in Ann Arbor and lead author of the study.

“Inappropriate catheter use is an important patient safety issue,” Saint says. “Often, caregivers are doing something patients do not like for indications the patients do not have. If they don’t need the device, it should be removed as soon as possible.”

The study found that 25 percent of all hospitalized patients will receive a catheter at some point in their stay. A catheter is a latex or silicon tube which is inserted into a patient’s urethra and bladder and allows urine to be emptied into a bag.

Catheters are considered necessary when a patient is bed-ridden, incontinent or unable to control urine flow, is in post-operative recovery, has a bladder obstruction such as an enlarged prostate, or needs to have urine levels observed.

Catheters can make it easier for health-care professionals to monitor fluids and to see blood in the urine, says Dr. Martin Resnick, secretary of the American Urology Association and a urologist with Case Western Reserve University in Cleveland. “It’s certainly not essential, but it is more convenient to have it,” he says. “I’m not sure it’s harmful, as long as it’s not used long term.”