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PEER-TO-PEER CLINICAL CONVERSATIONS
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Can a Catheter Tip Improve a Difficult Intermittent Catheterization? Curved Tip Catheters
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Diane Newman, DNP, CRNP, FAAN, BCB-PMD
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| Multiple intermittent catheterization attempts can cause anxiety and stress and can traumatize the urethra. Diane Newman discusses the importance of understanding the benefits of the catheter tip to eliminate difficulty with inserting a catheter for intermittent catheterization. Polished, smooth eyelets may decrease urethral trauma from repeated catheterizations.
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| Evolving Intermittent Catheter Technology: Review of Material
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| Diane Newman, DNP, CRNP, FAAN, BCB-PMD
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| Diane Newman discusses the innovation of materials used in intermittent catheters. In the data published this year, urinary retention patients had better outcomes with hydrophilic-coated intermittent catheters. There are several types of hydrophilic catheters and this review provides an overview.
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| Intermittent Catheter Types
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| Diane Newman, DNP, CRNP, FAAN, BCB-PMD
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| The increasing complexity of catheter technology has led to a variety of intermittent catheter types, incorporating gender-specific lengths, French catheter scale sizes, and diverse features such as eyelet placement and tip designs. These catheters can be categorized into coated and uncoated designs, with coated catheters, particularly those with hydrophilic coatings, being shown to reduce trauma and urinary tract infections.
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| Best Practices for Management - Intermittent Catheters
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| Diane Newman, DNP, CRNP, FAAN, BCB-PMD
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| Intermittent catheterization can significantly impact patients physically and emotionally, leading to concerns about discomfort, privacy, fear of catheterization, and difficulties finding appropriate facilities when outside the home. Successful management involves comprehensive patient education, with initial teaching and follow-up support, addressing potential dropout rates, and considering factors such as age, disabilities, and medical history.
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| Long-Term Outcomes of Urethral Catheterization Injuries: A Prospective Multi-Institutional Study - Beyond the Abstract
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| Niall Davis, Nikita Bhatt, Eoin MacCraith, Hugh Flood, Rory Mooney, G. Leonard, Michael Walsh
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| In a prospective study involving two tertiary referral university teaching hospitals, the long-term clinical outcomes and complications of patients with traumatic urethral catheterization-related injuries were monitored. The study, conducted between July 2015 and January 2016 with a follow-up period of 37 ± 3.7 months, recorded 37 iatrogenic urethral injuries caused by urinary catheterization. The incidence of urinary catheter-related urethral injuries was found to be 13.4 per 1,000 catheters inserted in male patients.
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| Intermittent Catheters - Teaching Self-Catheterization
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| Diane Newman, DNP, CRNP, FAAN, BCB-PMD
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| Diane Newman provides guidance on teaching patients self-catheterization. She emphasizes the ideal qualities for successful self-catheterization, including an unobstructed urethra, good vision, perineal care, and compliance. Newman discusses challenges with obese or tremor-affected patients and explores barriers to self-catheterization such as fear, decreased perineal sensation, and age.
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| Catheter Characteristics That May Improve Self-Catheterization
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| Mary A. Wasner, RN, BSN, CURN
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| Mary Wasner presents an assessment of catheter features aimed at improving intermittent catheterization (IC) and reducing infection risks. The focus is on catheter design considerations, including a protective tip that bypasses the initial 15 mm of the urethra to minimize contamination from microorganisms. Protective sleeves and bags are highlighted as barriers against contamination from hands and external surfaces, and Closed NoTouch Systems, which integrate protective tips and can be touched without contamination, are recommended and reimbursed by US Medicare.
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