Skip Navigation
Menu
Editorials |16 July 2002

Indwelling Urinary Catheters: A One-Point Restraint?

Sanjay Saint, MD, MPH; Benjamin A. Lipsky, MD; Susan Dorr Goold, MD, MHSA, MA

Article, Author, and Disclosure Information
Author, Article, 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.

×
FULL TEXT
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 (3-6).
Regrettably, unjustified and excessively prolonged catheter use persists despite clear evidence of its detrimental effects (7-9). Indwelling catheters have the practical effect of needlessly confining patients in what could be called a “one-point” restraint, raising serious safety and ethical concerns analogous to those noted more than a decade ago with “four-point” (limb) restraints. Lessons learned from efforts to curtail the use of physical restraints may help identify strategies for diminishing the use of indwelling urinary catheters.
Each year, almost 25% of the approximately 96 million urinary catheters sold worldwide are sold in the United States, where between 16% and 25% of hospitalized patients have an indwelling urinary catheter (9, 10). In a substantial proportion of these patients, the catheter is used inappropriately (7, 8). Two decades ago, a study of hospitalized patients found that catheter use...
FULL TEXT
PDF
Not Available
Citations
Citation

Saint S, Lipsky BA, Goold SD. Indwelling Urinary Catheters: A One-Point Restraint?. Ann Intern Med. 2002;137:125–127. doi: 10.7326/0003-4819-137-2-200207160-00012

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 2002;137(2):125-127.

DOI: 10.7326/0003-4819-137-2-200207160-00012

©
2002 American College of Physicians
113 Citations

Related Articles
The Ann Arbor Criteria for Appropriate Urinary Catheter Use in Hospitalized Medical Patients: Results Obtained by Using the RAND/UCLA Appropriateness Method
Annals of Internal Medicine; 162 (9_Supplement): S1-S34
In Pursuit of Appropriate Urinary Catheter Indications: Details Matter
Annals of Internal Medicine; 162 (9_Supplement): S35-S36
Review: Antibiotic prophylaxis on removal of urinary catheters reduces symptomatic urinary tract infections
Annals of Internal Medicine; 159 (8): JC9
Infection Risk with Nitrofurazone-Impregnated Urinary Catheters in Trauma Patients: A Randomized Trial
Annals of Internal Medicine; 147 (5): 285-293
View MoreView Less

Journal Club
Review: Antibiotic prophylaxis on removal of urinary catheters reduces symptomatic urinary tract infections
Annals of Internal Medicine; 159 (8): JC9
View MoreView Less

Related Topics
Hospital Medicine
Nephrology
Urological Disorders

Hospital Medicine, Nephrology, Urological Disorders.

PubMed Articles
Postoperative Urinary Tract Infection Quality Assessment and Improvement: The S.T.O.P. UTI Program and Its Impact on Hospitalwide CAUTI Rates.
Jt Comm J Qual Patient Saf 2019.
National Trends in Healthcare-Associated Infections for Five Common Cardiovascular Conditions.
Am J Cardiol 2019.
View More

Results provided by: PubMed

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×