According to some new research, nearly 1 out of every 3 patients undergoing catheterization doesn't need it.

In addition, once inserted, the devices often remain too long because doctors either forget or don't know they are there.

Researchers say that much of this over-catheterization may be due to the fact that it makes the jobs of hospital staff easier.

• Prolonged catheter use can lead to painful urinary tract infections and longer hospital stays, says one of the study's authors.

• "Inappropriate catheter use is an important patient safety issue," one researcher said. "Often, caregivers are doing something patients do not like for indications the patients do not have. If they don't need the device, it should be removed as soon as possible."

• The study found that 25 percent of all hospitalized patients will receive a catheter at some point in their stay.

• Researchers found that 28 percent of the time, doctors had forgotten or never knew which of their patients still had a catheter inserted.

Catheters are considered necessary when a patient is bed-ridden, incontinent or unable to control urine flow, is in post-operative recovery, has a bladder obstruction such as an enlarged prostrate, or needs to have urine levels observed.

According to Dr. Martin Resnick, secretary of the American Urology Association and a urologist with Case Western Reserve University in Cleveland. "It's certainly not essential, but it is more convenient to have it," he says. "I'm not sure it's harmful, as long is it's not used long term."

Increased Infection Risk

Every day a catheter is left in, a patient has a 5 percent chance of developing a urinary tract infection (UTI), as bacteria from the patient's genital area migrate up the outside of the catheter and infect the otherwise sterile bladder. Occasionally, this infection spreads to the bloodstream.

The incidence of UTIs is reduced, however, if silver alloy catheters are used (See Related Story This Week).

While these infections can usually be cured with antibiotics, they have the potential to lengthen hospital stays and cause more serious side effects that can be life threatening.

New Catheter Guidelines Proposed

As a result of their findings, researchers are calling for a mandatory "stop-order" on all hospital catheterizations after 48 hours, with a daily review thereafter.

In the meantime, researchers suggest that patients or their family members simply ask the doctor every day: "Do I still need the catheter?"

Dr. Resnick agrees that patients should become more proactive and "engaged" with health-care professionals about what is being done to them.

American Journal of Medicine October, 2000.