BERKELEY, CA (UroToday.com) - This was a retrospective electronic chart review of male veterans, managed by the Jesse Brown VA Medical Center in Chicago, who had been performing clean intermittent catheterization (CIC) for at least 3 months. The men used red rubber catheters, and catheters were re-used for one-week intervals. Data collected were the number of daily catheterizations, documentation of education, compliance regarding clean technique, medical specialty of the treating physician, rationale for antibiotic use, and antibiotic prescribed with duration.
Over a 5-year period (2002-2007), 515 male patients received red rubber catheters but 356 were excluded, yielding 159 patients who were included in the study. Reasons for CIC were urinary retention due to BPH, and urethral stricture. Average age was 69 and average length of CIC use was 26.1 months. Only a very small number (3.78%) had a caregiver perform catheterization, and on average CIC performed by the entire group was twice a day. As to UTIs, 95 patients (59.7%) were infection free and 64 (40.3%) were given antibiotics for presumed UTI, but the authors were only able to obtain UTI data on men treated at the VA. The group who developed UTIs had a higher daily number of catheterizations. The UTI group also had more instances in which clean technique education was not documented by nursing or medical staff.
The authors note that, in 2007, the Under Secretary for Health issued a directive that patients are to be instructed on catheters for single-use. Since then, CMS also began mandating insurance coverage of up to 200 catheters per month for patients who intermittently catheterize to avoid re-use of catheters.
Kannankeril AJ, Lam HT, Reyes EB, McCartney J
Reference: Urol Nurs. 2011 Jan-Feb;31(1):41-8
PubMed Abstract
PMID: 21542443
Written by Diane K. Newman, DNP, FAAN, BCB-PMD
