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Urinary Catheterization: a Paradigm Shift in Difficult Urinary Catheterization
Kristofer R Wagner1, Erin T Bird1, K Scott Coffield2
1Division of Urology, Department of Surgery, Texas A&M University Health Science Center College of Medicine/Baylor Scott & White Health, 2401 South 31st Street, Temple, TX, 76508, USA.
Insights
Difficult urinary catheterization can be improved with new techniques and education. Vision-guided urinary catheters may help nurses place catheters more successfully and efficiently, reducing patient complications.
Area of Science:
- Urology
- Medical Devices
- Patient Care
Background:
- Urinary catheterization is a common procedure with potential for patient harm.
- Difficult catheter placement often requires specialist consultation.
- Nursing personnel frequently perform urethral catheterization.
Purpose of the Study:
- To review the history and advancements in urinary catheterization.
- To analyze techniques and management of difficult urinary catheterization.
- To explore educational and technological solutions for improved catheter use.
Main Methods:
- Conducted a literature search on PubMed.gov and Ovid Medline.
- Included articles on catheter history, difficult catheterization, and iatrogenic injuries.
- Analyzed management algorithms and technological improvements.
Main Results:
- The history and technical advances of urinary catheters were reviewed.
- Outcomes and costs of catheter complications were discussed.
- Management algorithms and educational/technological advances were analyzed.
Conclusions:
- Enhanced provider education and skills improve urinary catheterization care.
- Current technology, with preparation, can optimize patient outcomes.
- Vision-guided catheters may aid nursing personnel in successful placement.
Background:
The urinary catheter is an ancient device for urinary drainage in patients. Placement of a urethral catheter is a common medical procedure that may have led to morbidity and mortality. Urethral catheterization is commonly performed by a nurse. Difficult catheter placement generates urology consultation. Difficult catheterization with a vision-guided urinary catheter may provide expedited and successful catheter placement by nursing personnel.
Methods:
A PubMed.gov and Ovid Medline search for articles on history of urinary catheter, difficult urinary catheterization, iatrogenic urethral injury, iatrogenic urethral injury and CAUTI, management of iatrogenic urethral injury, and techniques for urinary catheter placement was performed.
Results:
The history of urinary catheters is reviewed. Technical advances in the last century are discussed. Indications for catheter placement are included. Outcomes and cost of complications of urinary catheters are discussed relative to present practice quality standards. Review of difficult urinary catheterization management algorithms developed with urological catheter improvements during the last decade is analyzed. Educational and technological advances to improve outcomes of urinary catheter use are addressed.
Conclusions:
Provider attention to issues of urinary catheterization is enhanced by education and additional skills for catheterization. Physician and nurse providers can use current technology with preparation to improve the catheterization care of patients.
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