The use and management of closed urinary catheters
Abstract
The use and management of urinary catheters has been widely researched in the human field, and to a lesser extent in the veterinary field for many decades. The catheterisation of the urinary bladder via the urethra and the methods of collecting the draining urine from catheters is deemed an important area of clinical research due to the high risk of the development of urinary tract infections (UTIs), and specifically catheter-associated urinary tract infections (CAUTIs) in hospitalised patients. This article aims to explore the literature available, both human and veterinary, relating to urinary catheterisation and the methods of collection, and provide recommendations for the use of urinary catheters and closed-collection systems in veterinary practice in an effort to reduce the number of CAUTI cases.
In veterinary practice, registered veterinary nurses (RVNs) and veterinary nursing students are involved in the nursing of patients requiring urinary catheterisation, and the management of patients with indwelling urinary catheters (IDUC). As discussed by Branscombe (2012), invasive procedures such as urinary catheterisation are tasks that trained professionals such as RVNs are allowed to perform, and their placement and management are tasks which should not be delegated to untrained lay people. Sedor and Mullholland (1999) stated that approximately 30 to 40% of all nosocomial infections documented in humans are UTIs that develop post catheterisation, and approximately 15% of blood stream infections in human patients are a consequence of a urinary tract infection (UTI) (Maki and Tambayh, 2001; Leone et al, 2003). Ogeer-Gyles et al (2006) highlighted that the frequency and justification of urinary bladder catheterisation in veterinary patients is similar to humans, so RVNs must be aware of the likelihood of nosocomial infection development, now termed hospital-acquired infections (HAIs). Being aware of the risk factors for the development of catheter-associated urinary tract infections (CAUTIs) will enable the RVN to improve their management of such cases. This includes a better knowledge regarding the development of UTIs, or bacteriuria, and the equipment and consumables available to reduce the incidence of infection, such as closed-collection drainage systems (CCDS).
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