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Indwelling Urinary Catheters: A One-Point Restraint?

Sanjay Saint, MD, MPH; Benjamin A. Lipsky, MD; and Susan Dorr Goold, MD, MHSA, MA
[+] Article, Author, and Disclosure Information

Disclaimer: Dr. Saint has received an honorarium from C.R. Bard, Inc., and serves as a consultant to UroSolutions, Inc.

Grant Support: Dr. Saint is supported by a Career Development Award from the Veterans Affairs Health Services Research & Development Program. Dr. Goold is supported by a Robert Wood Johnson Generalist Physician Faculty Award.

Request for Single Reprints: Sanjay Saint, MD, MPH, Patient Safety Enhancement Program, University of Michigan Health System, Room 7E08, 300 NIB–Campus Box 0429, Ann Arbor, MI 48109-0429; e-mail, saint@umich.edu.

Current Author Addresses: Dr. Saint: University of Michigan Health System, Division of General Medicine, Room 7E08, 300 NIB, Campus Box 0429, Ann Arbor, MI 48109-0429.

Dr. Lipsky: VA Puget Sound Healthcare System, General Internal Medicine Clinic (S-111-GIMC), 1660 South Columbian Way, Seattle, WA 98108.

Dr. Goold: University of Michigan Health System, Division of General Medicine, Room 7B19, 300 NIB, Campus Box 0429, Ann Arbor, MI 48109-0429.

Ann Intern Med. 2002;137(2):125-127. doi:10.7326/0003-4819-137-2-200207160-00012
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More than four decades ago, Dr. Paul Beeson persuasively argued against routine use of indwelling urinary catheters in hospitalized patients, making the “case against the catheter” (1). He urged, “The decision to use this instrument should be made with the knowledge that it involves risk of producing a serious disease” (1). This advice remains relevant today. Although these devices provide indispensable benefits, they are also the dominant risk factor for hospital-acquired urinary tract infection, the most common nosocomial infection in the United States (2). Infections and other untoward effects associated with indwelling urinary catheters lead to increased health care costs, patient discomfort, morbidity, and even death (36).

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