Prevention of Urinary Tract Infections With Early Removal
Prevention of Urinary Tract Infections With Early Removal
Chris Lowe
University of Mary Washington
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Prevention of Urinary Tract Infections With Early Removal
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Prevention of Urinary Tract Infections With Early Removal
Urinary catheters are widely used in the medical field and because of that urinary tract
infections (UTIs) are extremely prevalent. While there are many benefits with the
implementation of urinary catheters, the major downfall is infections due to prolonged days and
poor early removal. According to Marklew, (2004), “UTI is inevitable and unavoidable and after
14 days there will almost certainly be bacteria in the bladder, which will generally be resistant to
antibiotic therapy” (P. 23). If the nurses become more proactive with assessing who needs early
removal, the incidences of UTIs would drastically decrease and lead to better patient outcomes.
In order to achieve this more education on proper care needs to be offered and the nurses need to
be more proactive with the removal of catheters once deemed not necessary. By implementing
these steps, infection rates will decrease which will lead to shorter length of stays, decreased
financial obligations to the patient and institution, and better patient outcomes.
Bernard, M. S., Hunter, K. F., & Moore, K. N. (2012) conducted a study to evaluate the
incidents of urinary tract infections and early removal. They found that not only was there an
increase of UTIs associated with longer length of catheter use, they also found that many times
catheters were used without clear indications. Furthermore, catheter associated urinary tract
infections (CAUTIs) place a financial burden on the health care system by increasing the length
of stay. Research was conducted by doing a search of electric databases, where fifty-three
abstracts were analyzed and it was found that nine were relevant to research questions. Nine
studies were found on the reduction of catheter use that correlated with a decrease in CAUTIs.
They found that nurse led interventions to assess if continued catheter use is indicated and the
Prevention of Urinary Tract Infections With Early Removal
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implementation of standing protocols led to a consistent decrease in CAUTIs, form 11.5 to 8.3
per 1000 catheter days (Bernard et al., 2012).
By routinely assessing the need for continued catheter use and establishing standing
protocols that allows the nurse to independently deem the catheter unnecessary, the number of
CAUTIs will decrease and ultimately lead to shorter hospital stays. Due to the current Medicare
and Medicaid reimbursement system hospitals no longer receive payment for CAUTIs, so by
being more vigilant with assessing the need for catheter removal and by working with the
interdisciplinary team nurses will not only improve patient outcomes but also save money for the
institution. This study has proved that early removal of catheters leads to decreased infection
rates, which in turn leads to a decreased financial burden on the institution. By setting standard
protocols for removal nurses would be better utilized and actively decrease CAUTI rates.
In conclusion, catheters serve their place in the hospital and in fact are needed in certain
situations to help the patient. With that being said if not monitored properly and removed when
no longer needed, patient mortality rates can increase due to infections and the hospital and
patient can sustain a financial hardship. It is up to the nurses too not only be diligent with early
removal but also to communicate to the physician and advocate for the patient. Nurses are in the
unique position to advocate for the patient because of the amount of time spent with patients and
family. Because of this it is important that the nurse make the physicians aware of which
patients have catheters that might not be necessary (Mason, Leavitt, & Chaffee, 2014).
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References
Bernard, M. S., Hunter, K. F., & Moore, K. N. (2012). A Review of Strategies to Decrease the
Duration of Indwelling Urethral Catheters and Potentially Reduce the Incidence
of Catheter- Associated Urinary Tract Infections. Urologic Nursing, 32(1), 29-37.
Marklew A. Urinary catheter care in the intensive care unit. Nursing In Critical Care [serial
online]. 2004 Jan-Feb 2004;9(1):21-27.
Mason, D., Leavitt, J., & Chaffee, M. (2014). Policy & politics in nursing and health care (Sixth
ed.). St. Louis, Missouri: Elsevier Saunders.