Internal and External Urinary Catheters: A Primer for Clinical Practice
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The introducer tip also keeps the catheter straight as it is advanced, and, when squeezed, prevents it from slipping during insertion. 35
Advancements. Manufacturers have designed internal and external catheters that are compact and easy to use. Two recently introduced products include the “SpeediCath” (Coloplast Corp, Minneapolis, MN) for men and women. The one for woman can fit easily in a small purse or bag (see Figure 10). An EC with tabs to aid in rolling the self-adhesive, silicone EC over the shaft of the penis can be folded neatly in a compact that can fit in a man’s pocket (see Figure 11).
Silver alloy-coated catheters. Hospitals are considering using silver alloy-coated catheters to prevent or reduce CAUTIs. Silver alloy-coated catheters are believed to reduce the risk of inflammation and infection because they reduce microbacterial adherence and migration of bacteria to the bladder. 2 Silver alloy-coated catheters may provide more benefits than standard latex catheters for short-term catheterization in some populations because they may reduce the risk of asymptomatic bacteriuria. 63-65 A Cochrane review66 noted that the effect of silver alloy catheters compared to latex catheters is more pronounced when used in patients catheterized <1 week; no differences were observed when the silver alloy catheters were compared to standard, all silicone catheters
There is very little evidence-based research to direct clinical nursing practice on the use of internal and external catheters. Newman et al3 advocated an integrated collaboration among industry, clinicians, and researchers to determine and prioritize questions to be investigated; have input into the design, procedures, and outcome measures; allow joint ownership of findings in a transparent and traceable manner; interpret results with the benefit of multiple perspectives; and be assured results would be disseminated.
The goal for use of an internal and/or external catheter is either for the person to remain as dry as possible or to ensure complete bladder drainage. Although catheters are an integral part of the nursing care of patients with bladder dysfunction, there is little to no research in the United States on their long-term use. Nurses play a major role in bladder management of their patients; as such, they should acquire the knowledge necessary to provide care that demonstrates clinical, regulatory, and financial awareness of prudent catheter use.
1. Wong ES, Hooten TM. Guidelines for the prevention of catheter-associated urinary tract infections. In: Guidelines for the Prevention and Control of Nosocomial Infections. Centers for Disease Control and Prevention. Available at: www.cdc.gov/ncidod/dhqp/gl_catheter_assoc.html. Accessed December 27, 2007.
2. Newman DK, Wein AJ. Managing and Treating Urinary Incontinence, 2nd Edition. Baltimore, MD: Health Professions Press;2009 (in press).
3. Newman DK, Fader M, Bliss DZ. Managing incontinence using technology, devices and products. Nurs Res. 2004;53(6 suppl):S42–S48.
4. Centers for Medicare and Medicaid Services. State Operations Manual, Appendix PP—Guidance to Surveyors for Long-Term Care Facilities, Tag F315, §483.25(d) Urinary Incontinence. Available at: www.cms.hhs.gov/transmittals/downloads/R8SOM.pdf. Accessed November 11, 2007.
5. Newman DK. The indwelling urinary catheter: Principles for best practice. JWOCN. 2007;24(6):655–661.
6. Newman DK. Nursing management: renal and urologic problems. In: Lewis SL, Heitkemper MM, Dirksen SR, Brien PG, Bucer L, (eds).