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Jennifer Meddings, MD, MSc; Sanjay Saint, MD, MPH; Karen E. Fowler, MPH; Elissa Gaies, MD, MPH; Andrew Hickner, MSI; Sarah L. Krein, PhD, RN; and Steven J. Bernstein, MD, MPH

Interventions to reduce urinary catheter use involve lists of “appropriate” indications developed from limited evidence without substantial multidisciplinary input. To refine criteria for appropriate catheter use—defined as use in which benefits outweigh risks—the RAND/UCLA Appropriateness Method was applied. A 15-member multidisciplinary panel of physicians, nurses, and specialists in infection prevention reviewed the literature and rated scenarios for catheter use as appropriate, inappropriate, or of uncertain appropriateness by using a standardized, multiround rating process. These new appropriateness criteria can inform large-scale collaborative and bedside efforts to reduce inappropriate urinary catheter use.

Topics: catheter device, appropriateness, urinary catheter, catheter, foley, urinary incontinence

The editorialist discusses Medding and colleagues' article on the appropriate use of urinary catheters in hospitalized medical patients and stresses that we need to focus on the details: the specifics of patient conditions, needs for monitoring, nursing care processes, available alternatives, and the equipment needed.

Topics: urinary catheter
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