title: Appropriate use of indwelling urethra catheters in hospitalized patients: results of a multicentre prevalence study.
abstract: BACKGROUND
  Although indwelling urethra catheterization is a medical intervention with well-defined risks, studies show that approximately 14-38% of the indwelling urethra catheters (IUCs) are placed without a specific medical indication. In this paper we describe the prevalence of IUCs, including their inappropriate use in the Netherlands. We also determine factors associated with inappropriate use of IUCs in hospitalized patients.
  
  
  METHODS
  In 28 Dutch hospitals, prevalence surveys were performed biannually in 2009 and 2010 within the PREZIES-network. All patients admitted to a participating hospital and who had an IUC in place at the day of the survey were included. Pre-determined criteria were used to categorize the indication for catheterization as appropriate or inappropriate.
  
  
  RESULTS
  A total of 14,252 patients was included and 3020 (21.2%) of them had an IUC (range hospitals 13.4-27.3). Initial catheter placement was inappropriate in 5.2% of patients and 7.5% patients had an inappropriate indication at the day of the survey. In multivariate analyses inappropriate catheter use at the time of placement was associated with female sex, older age, admission on a non-intensive care ward, and not having had surgery. Inappropriate catheter use at the time of survey showed comparable associated factors.
  
  
  CONCLUSIONS
  Although lower than in many other countries, inappropriate use of IUC is present in Dutch hospitals. To reduce the inappropriate use of IUCs, recommended components of care (bundle for UTI), including daily revision and registration of the indication for catheterization, should be introduced for all patients with an IUC. Additionally, an education and awareness campaign about appropriate indications for IUC should be available.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment-RIVM, PO Box 1-Postbak 75, 3720 BA, Bilthoven, The Netherlands.
authors.forename: Irálice A V
authors.initials: IA
authors.lastname: Jansen
authors.forename: Titia E M
authors.initials: TE
authors.lastname: Hopmans
authors.forename: Jan C
authors.initials: JC
authors.lastname: Wille
authors.forename: Peterhans J
authors.initials: PJ
authors.lastname: van den Broek
authors.forename: Tjallie I I
authors.initials: TI
authors.lastname: van der Kooi
authors.forename: Birgit H B
authors.initials: BH
authors.lastname: van Benthem
mesh_terms: D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000706:statistics & numerical data*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D014546:Urinary Catheterization / Q000009:adverse effects / Q000706:statistics & numerical data*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control