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How do doctors spell relief?
CATHETER.
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.
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Prolonged catheter use can lead to painful
urinary tract infections and longer hospital stays,
says one of the study's authors.
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"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."
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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.
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