title: The effect of urinary bladder catheterization on patient care in an internal medicine department.
abstract: BACKGROUND
  Recommendations for urinary catheterization in newly hospitalized patients are inconsistent and unclear.
  
  
  METHODS
  The authors studied prospectively consecutive patients who were catheterized in an internal medicine department over a 3-month period, with follow-up for 6 months or until the catheter was removed. Patient records were reviewed to determine if catheterization was definitely not indicated by commonly accepted criteria. After chart review, a category of possibly not indicated was defined as having no demonstrable effect on patient care.
  
  
  RESULTS
  There were 17.7% patients (122/691) catheterized during their admission. According to accepted criteria, definite inappropriate catheterization occurred in 18 patients (14.7%). There were an additional 69 patients (56.6%) with unclear clinical benefits, hospitalized because of fever, acute congestive heart failure, a cerebral vascular accident or respiratory insufficiency due to exacerbation of chronic obstructive lung disease. During hospitalization, attempts to remove the catheter failed in 13 patients, 4 of who remained with the catheter permanently, complicated by urosepsis in 1 patient.
  
  
  CONCLUSIONS
  Over 50% of the patients had acceptable indications for catheterization but no demonstrable benefit from the procedure. In such patients, the uncertain benefits of catheterization should be balanced by potential complications. Additional studies are warranted to determine the effect of acute urinary catheterization on patient care.
authors.affiliation: Internal Medicine B, Laniado Hospital, Netanya, Israel.
authors.forename: Zvi
authors.initials: Z
authors.lastname: Shimoni
authors.forename: Michael
authors.initials: M
authors.lastname: Mullerad
authors.forename: Mark
authors.initials: M
authors.lastname: Niven
authors.forename: Zeev
authors.initials: Z
authors.lastname: Feuchtwanger
authors.forename: Paul
authors.initials: P
authors.lastname: Froom
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D020878:Device Removal; D005260:Female; D006748:Hospital Departments; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007388:Internal Medicine; D007557:Israel / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011446:Prospective Studies; D019564:Unnecessary Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000706:statistics & numerical data*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology*