Catheter Use in Nursing Homes - Nursing Home Minnesota Elder Abuse and Neglect Attorney Kenneth LaBore

Catheter Use - Preventable Urinary Tract Infections UTIs — Catheter Use – Preventable Urinary Tract Infections UTIs

Catheter Use Comes with Risks

UTI from Catheter Use – According to MedlinePlus, a urinary tract infection, or “UTI,” is an infection that can occur in the kidneys, in the tubes that take urine from the kidneys to the bladder, or in the bladder. An indwelling catheter (tube) in your bladder – “Indwelling” means inside the body. This catheter drains urine from the bladder into a bag outside the body.

When you have an indwelling urinary catheter, you are more likely to develop a UTI. These infections are more likely if you have the catheter in place for a long time.
Bacteria cause most UTIs that are related to having a catheter. A fungus called Candida [Yeast Infection] can also cause UTIs.

Catheter Associated Urinary Tract Infections

According the CDC – Catheter-Associated Urinary Tract Infection – if you have a urinary catheter, germs can travel along the catheter and cause an infection in your bladder or your kidney; in that case it is called a catheter-associated urinary tract infection (or “CA-UTI”). A urinary catheter is a thin tube placed in the bladder to drain urine. Urine drains through the tube into a bag that collects the urine.

Nursing home residents often require the indwelling catheter use, however many others are given a catheter in short for the convenience of the staff in that they need not transfer and toilet the resident as often. Beyond the violation to the body and associated pain and discomfort and the limiting of movement and freedom for the resident, the catheter brings an increased risk of urinary tract infection due to the foreign body being placed into the body.

42 CFR 483. Nursing Home Regulations also require that each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.

(d) Urinary Incontinence. Based on the resident’s comprehensive assessment, the facility must ensure that—

(1) A resident who enters the facility without an indwelling catheter is not catheterized unless the resident’s clinical condition demonstrates that catheterization was necessary; and
(2) A resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible.

Catheter care – Center for Disease Control and Prevention

Healthcare providers clean their hands by washing them with soap and water or using an alcohol-based hand rub before and after touching your catheter.
Avoid disconnecting the catheter and drain tube. This helps to prevent germs from getting into the catheter tube.
The catheter is secured to the leg to prevent pulling on the catheter.
Avoid twisting or kinking the catheter.
Keep the bag lower than the bladder to prevent urine from backflowing to the bladder.
Empty the bag regularly. The drainage spout should not touch anything while emptying the bag.
If you do not see your providers clean their hands, please ask them to do so.

According to an article in NCBI, there has been a recent upsurge of interest in prevention of CAUTI and a proliferation of guidelines in this area. Social changes in US government reimbursement to hospitals and public reporting of hospital-acquired infections may underlie this interest. The awareness that CAUTI and catheter-associated asymptomatic bacteriuria (CA-ASB) are distinct conditions is increasing, but unnecessary treatment of ASB remains quite prevalent. The focus in recent CAUTI literature is on prevention, often through strategies to minimize urinary catheter use. Very little new evidence is available to guide diagnosis and treatment strategies.

Here is some additional information about urinary infections