Catheter-associated urinary tract infection is a common and costly problem throughout the world. As limited data from Asia exist regarding the prevalence and appropriateness of urinary catheters in critically ill patients, we sought to assess both prevalence and appropriateness of urinary catheters in Japan.
Using independent observers, we evaluated the prevalence and clinical necessity of indwelling urinary catheters in 7 Japanese intensive care units.
Data were collected on 1289 catheter-days and 1706 patient days in the 7 participating intensive care units between August 2015 and May 2016. Urinary catheter prevalence was 76% (range, 49%-94%). The observers deemed that only 54% of the catheters met an appropriate indication for use (range, 40%-74%). The most common appropriate indications for urinary catheter use were (1) the need for accurate input and output monitoring in critically ill patients; (2) perioperative use; and (3) prolonged immobilization. The use of monitoring accurate input and output in critically ill patients, however, may be overused as bedside nurses used this indication in 27% more patients than the objective observer deemed necessary.
Urinary catheters were frequently used in the 7 participating Japanese intensive care units and almost half did not meet an appropriate indication for use. Overusing catheters for monitoring accurate input and output was especially notable. Multimodal interventions may be needed to limit inappropriate urinary catheter use.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2017 May 15 [Epub]
Akira Kuriyama, Tadaaki Takada, Hiromasa Irie, Masaaki Sakuraya, Kohta Katayama, Daisuke Kawakami, Hiroshi Iwasaki, Karen E Fowler, Yasuharu Tokuda, Sanjay Saint
Department of General Medicine/Emergency Intensive Care Unit, Kurashiki Central Hospital, Okayama., Department of Emergency and Critical Care, Urasoe General Hospital, Okinawa., Department of Anesthesiology, Kurashiki Central Hospital, Okayama., Department of Emergency Service/Intensive Care Unit, JA Hiroshima General Hospital., Department of General Medicine, Mito Kyodo General Hospital, and., Department of Anesthesiology and., Critical Care Center, Kobe City Medical Center General Hospital, Japan., Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Michigan., Japan Community Healthcare Organization, Tokyo; and.