| Learning Objective #1: Learn of the evidence for the nursing management of hospitalised adults requiring indwelling urinary catheterisation | |||
| Learning Objective #2: Understand the impact of nursing decision making on the outcomes of hospitalised adults with an indwelling urinary catheter |
A systematic review (including metanalyses) was completed with the Cochrane Incontinence Review Group. 18 studies met the inclusion criteria: antiseptic impregnated catheters versus standard catheters, which included silver oxide (n=3 trials) and silver alloy (n=8 trials), antibiotic impregnated catheters versus standard catheters (n=1 trial) and comparisons of different types of standard catheters (n=6 trials).
Silver oxide catheters were not found to prevent bacteriuria in short-term catheterised hospitalised adults (RR 0.87, 95% CI 0.68 to 1.13). Silver alloy catheters were found to significantly reduce the incidence of asymptomatic bacteriuria (RR 0.36, 95%CI 0.25 to 0.52.) in hospitalised adults catheterised for less than one week. At greater than one week catheterisation the risk of asymptomatic bacteriuria was still reduced with the use of silver alloy catheters (RR 0.67, 95%CI 0.50 to 0.90). The risk of symptomatic urinary tract infection was found to be also reduced with the use of silver alloy catheters (RR 0.60, 95%CI 0.50 to 0.73).
Silver alloy indwelling catheters appear to reduce the risk of catheter acquired urinary tract infection in hospitalised adults catheterised short-term. Cost benefit analyses indicate that compensation for increased cost of silver alloy catheters would come from the reduction in the cost of catheter acquired urinary tract infection.
This review provides not only nurses and nurse managers, but also other health professionals with evidence of effectiveness to influence catheter choice.
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Sigma Theta Tau International
July 21, 2004