Appropriate versus Inappropriate urinary catheterization: A cross-sectional study in a Tertiary Care setup.

Abstract

Objective: To determine the frequency and appropriateness of urinary catheterization among adult patients admitted to the medical and surgical wards of a tertiary care hospital and the most common indication for each. Study Design: Cross-sectional Descriptive study. Setting: Abbasi Shaheed Hospital, Karachi. Period: April 1, 2021, to April 30, 2021. Methods: All adult patients of both genders admitted to the medical and surgical wards, including their respective sub-specialties, were included in the study, while the pediatric patients were excluded. Data was collected from all catheterized patients, including demographic characteristics and the indications for catheterization, regardless of the duration of catheter use. The appropriateness of catheterization was recorded based on established clinical indications. Results: Among 712 admitted patients, 348 (48.8%) were catheterized with an indwelling urinary catheter. Of the 348 catheterized patients, 210 (60.3%) were appropriately catheterized, whereas 138/348 (39.6%) patients were inappropriately catheterized. Altered state of sensorium was found to be the most common reason for catheterization whereas catheterization secondary to urinary incontinence without sufficient skin breakdown was found to be the most common reason for inappropriate catheterization. Conclusion: The frequency of inappropriate urinary catheterization at our tertiary care setup was found to be 39.6%, which is alarmingly high. These numbers highlight that a significant number of admitted patients are catheterized without a valid indication. These inappropriate catheterizations can be avoided, thereby preventing the complications related to urinary catheterization. The study results highlight the need for strict implementation of guidelines which will not only reduce the complication but will also cause financial benefit to the patients.