Symposium: Consensus and controversy in urinary drainage systems: Implications for improving patient safety

Moderator
Mikel Gray PhD, FNP, PNP, CUNP, CCCN, FAANP, FAAN
Panelists
Angela C. Joseph RN, MSN, CURN
David M. Mercer RN, MSN, APRN-BC, CFCN, CWOCN
Diane K. Newman RNC, MSN, CRNP, FAAN
Eric Rovner MD

Despite remarkable progress in the devices and technology that support healthcare practices, little has changed about the design of the indwelling urinary catheter since it was introduced in the 1930s. However, ongoing changes in the Center for Medicare and Medicaid Services prospective payment system for inpatient services has focused considerable attention on potentially preventable nosocomial events, including catheter-associated urinary tract infections (UTIs). This increased scrutiny has prompted clinicians to question not only indications and techniques for indwelling urinary catheterization but also the materials, size, and other features of the optimal catheter. This scrutiny has further led clinicians to reexamine the design of the urinary drainage system, including its ability to safely and promptly drain urine from the bladder into a reservoir, its ability to prevent backflow of urine from the drainage system into the bladder, and its influence on the risk of catheter-associated UTI. In order to gain a better understanding of these issues, a panel of expert clinicians—a urologist, urological nurse practitioners, a clinical nurse specialist, and a wound, ostomy and continence nurse—was asked to respond to 7 questions about urinary drainage systems. Specific questions focused on design features of optimal urinary drainage systems, challenges faced by patients managed by short- and long-term indwelling catheters, and the potential for urinary drainage systems to reduce UTI risk.

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