ANN ARBOR, Mich. - Hospital doctors have a lot to remember about each patient as they make their rounds. But many of them could use some reminding about a common and risky source of hospital-acquired infections that lies just under the bed covers: urinary catheters.

So finds a multi-center study led by University of Michigan researchers and published in the Oct. 16 issue of the American Journal of Medicine. Overall, the authors report, doctors in the study weren't sure of patients' catheter status more than a quarter of the time. And, perhaps as a result, the researchers found that nearly one-third of patients using catheters didn't need them - putting them in needless discomfort and at unnecessary risk for urinary tract infections.

"If out of sight means out of mind, as these findings suggest, then we must find a way to prompt physicians to check each patient's catheter use and make sure it's necessary," says Sanjay Saint, M.D., MPH, assistant professor of internal medicine at the U-M Health System and leader of the study. "We will likely cut infection risk by reducing inappropriate catheterization."

Catheters are often left in when a patient comes to a hospital floor from surgery, the emergency room or the intensive care unit. But their use can lead to patient discomfort and urinary tract infections - which make up 40 percent of hospital-acquired infections - and can extend hospital stays.

Saint and his colleagues studied 256 doctors - from medical students to attending physicians - working in teams on the general medicine floors of four teaching hospitals. They surveyed the professionals without warning before morning rounds, giving them a list of the patients in their care and asking which ones had catheters the previous day, and why. The authors then checked the patients to see if they actually had catheters the previous day and whether they were needed.

Overall, 25 percent, or 117, of the 469 patients had catheters, a rate typical of
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
12-Oct-2000