While even under the best circumstances urinary catheterization is decidedly unpleasant, for some patients the use of a catheter can actually do more harm than good.
Since 2009, the CDC's short list of appropriate and inappropriate urinary catheter uses has been the standard for determining patient candidacy, but new guidelines published in the Annals of Internal Medicine
may provide a broader analysis of the situation.
"In general, because urinary catheters increase the patient's risk of infection and other complications such as pain and scarring of the urinary tract, they should only be used when teams have no other way to assess a patient's urine or his or her fluid status," says Dr. Jennifer Meddings, lead author of the paper and an assistant professor of internal medicine at the University of Michigan Medical School.
While approximately one in five hospital patients today receive a Foley catheter, the new criteria suggest that far fewer should. The guidelines also point out that each day of catheterization increases the risk of complications, so in that sense less is sometimes more.
The guidelines, called the Ann Arbor Criteria for Urinary Catheter Appropriateness, include criteria for choosing between three different types of urinary catheters. Appropriate selection between different types of catheter was not addressed in the CDC guidelines published six years ago.
The complete findings can be read online here