Professor highlights link between use of catheters and urinary tract infections

Clinical nurse specialist Jacqui Prieto says catheters should be removed as soon as possible 

Overuse of catheters is putting patients at risk from infections, a patient safety conference has heard.

Picture: iStock

University of Southampton associate professor and clinical nurse specialist Jacqui Prieto said the role of catheters in urinary tract infection (UTI) prevalence could not be underestimated.

‘The second most common infection found in healthcare is UTI,’ she said in her talk on healthcare-associated infections at the Patient Safety Congress 2018 in Manchester on Monday.

Quoting figures from the English surveillance programme for antimicrobial utilisation and resistance report, she said: ‘Around 45% of UTIs are related to indwelling urinary catheterisation, and around a third of bloodstream infections are caused by UTIs.

‘This tells us that catheter-associated UTIs, and UTIs in general, are important clinical problems.’

‘Ubiquitous’ use of catheters

Dr Prieto said one in five patients in hospital, and one in fourteen in community settings, had a catheter installed during care, and that their use was ‘ubiquitous’. 

‘We see them all the time, they’re normal to us,’ she said at the congress, which was organised by Health Service Journal, with Nursing Standard as a media partner.

‘Patients accept that they are sometimes a normal aspect of care.’

But Dr Prieto argued that this normalisation played down the risk the devices posed to patients.

She said 25% of individuals with a catheter installed for between two to ten days would develop bacteria urea (bacteria in the urine), with the risk rising the longer the device was in place.

‘This might sound fairly innocuous, but bacteria urea is associated with a three-times increased risk of death.

‘A quarter of patients with bacteria urea go on to develop UTIs, and more than 3% will develop a bloodstream infection.’

Early removal

Dr Prieto said catheters were sometimes left in place too long for purposes such as monitoring urine levels. She said they should be removed as soon as possible for the patient’s safety.

‘We do use them routinely and sometimes as a first resort rather than a last,’ she said.

She highlighted other non-invasive options for urine monitoring, such as the weighing of bedpans, which she said were often used in paediatric settings but not in adult care.

Related material

The RCN's Infection Prevention and Control Commissioning Toolkit: Guidance and information for nursing and commissioning staff in England

English surveillance programme for antimicrobial utilisation and resistance (ESPAUR)

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