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S T A M P I N G
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Appropriate use only
Every CAUTI prevention guideline urges providers, first and foremost, to use catheters only when necessary. "The main issue is
overuse or inappropriate use," says Thomas Hooton, MD, a professor at the University of Miami (Fla.) School of Medicine and lead
author of the IDSA's 2009 clinical practice guidelines on CAUTI.
"It's estimated that 30% to 40% of those who are implanted with a
catheter don't need it. In long-term care, for instance, a lot of times
a catheter is put in for the convenience of staff."
In the outpatient setting, a catheter might be inserted to facilitate
voiding when a surgical site impacts a patient's bladder or affects the
ability to urinate, such as in general, GYN and urological surgery. But
IDSA guidelines discourage their use for managing incontinence.
Catheters are a go-to solution for treating patients who appear
to be suffering from post-op urinary retention, but technology
may provide a simpler, less invasive option. Scanning the bladder
with a portable ultrasound device can measure urine volume, possibly ruling out retention and needless catheterization. "A bladder
scan can help select out who needs to be catheterized," says Dr.
Hooton. "It makes sense and is quite useful." It's not a standard of
care, but the CDC's guidelines describe bladder-scanning technology as "a promising technology for CAUTI prevention," and a
review by Italian researchers in the Nov. 2010 Journal of Clinical
Nursing showed its effectiveness.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2012
