Hey doc, do I still need this catheter?

ANN ARBOR, Mich. -- Millions of hospital patients could be spared the humiliation and infection risk that come with a urine-collecting catheter, a new study finds, if hospitals used a simple reminder system to prompt doctors to remove the devices after two days.

About 25 percent of hospital patients at any given time have urinary catheters -- and a substantial proportion of patients have them much longer than they really need them, experts say. This greatly raises their risk of getting a painful urinary tract infection or even a blood infection.

But a new University of Michigan Health System study, funded by a patient safety grant from the Blue Cross Blue Shield of Michigan Foundation, shows that simply having nurses flag patients' records with a written reminder can jog the memory of busy doctors, prompt them to consider removing the catheter, and lead to a much shorter time with a catheter for many patients. The study is published in the August issue of the Joint Commission Journal on Quality and Patient Safety.

The written-reminder system isn't expensive, and in fact the study finds that its cost equals or is less than the savings that a hospital could achieve by reducing infections among patients. An estimated 40 percent of infections developed by patients during their hospital stay are urinary tract infections, and most of these infections are due to urinary catheters. The cost of treating each infection that causes symptoms is estimated to be at least $500.

"Doctors are responsible for ordering the removal of catheters, but research has shown that many of them forget which patients have catheters and how long they have them," says lead author Sanjay Saint, M.D., M.P.H., a hospitalist at the VA Ann Arbor Healthcare System and an associate professor of internal medicine at the U-M Medical School. "Our reminder system helps doctors do the right thing," he adds.

"Catheter reminders may become automatic as hospi

Contact: Kara Gavin
University of Michigan Health System

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