title: Prevalence of dependent loops in urinary drainage systems in hospitalized patients.
abstract: OBJECTIVE
  The purpose of this study was to measure the prevalence and configuration of dependent loops in urinary drainage systems in hospitalized, catheterized adults.
  
  
  METHODS
  The study sample comprised 141 patients with indwelling urinary catheters; subjects were hospitalized at an academic health center in northern Florida.
  
  
  METHODS
  We measured the prevalence of dependent loops in urine drainage systems and the incidence of urine-filled dependent loops over a 3-week period. We measured the heights of the crest (H(c)), trough (H(t)), and, when urine-filled dependent loops were present, the patient-side (H(p)) and bag-side (H(b)) menisci with a laser measurement system. All variables were measured in centimeters.
  
  
  RESULTS
  The majority of observed urine drainage systems (85%) contained dependent loops in the drainage tubing and 93.8% of the dependent loops contained urine. H(c) and H(t) averaged 45.1 ± 11.1 and 27 ± 16.7 cm, respectively. Meniscus height difference (H(b) - H(p)) averaged 8.2 ± 5.8 and -12.2 ± 9.9 cm when H(p) < H(b)(65.3%) and H(p) > H(b) (32.7%), respectively.
  
  
  CONCLUSIONS
  We found that dependent loops are extremely common in urinary drainage systems among hospitalized patients despite the manufacturer recommendations and nursing and hospital policies. Maintaining the urine drainage tubing free of dependent loops would require incorporation into nursing care priorities and workflow as inadvertent force on the tubing, for example, patient movement or nurse contact can change tubing configuration and allow excess drainage tubing to re-form a dependent loop.
authors.affiliation: Gale Danek, RN, PhD, Nursing Research, UF Health Shands Hospital, Gainesville, Florida. Nikolaus Gravenstein, MD, Anesthesiology, Department of Anesthesiology, University of Florida College of Medicine, and Center for Safety, Simulation & Advanced Learning Technologies (CSSALT), University of Florida, Gainesville. David E. Lizdas, BSME, Department of Anesthesiology, University of Florida College of Medicine, and Center for Safety, Simulation & Advanced Learning Technologies, University of Florida, Gainesville. Samsun Lampotang, PhD, Anesthesiology, CSSALT, Clinical & Translational Science Institute Simulation Core, University of Florida College of Medicine, Gainesville.
authors.forename: Gale
authors.initials: G
authors.lastname: Danek
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Gravenstein
authors.forename: David E
authors.initials: DE
authors.lastname: Lizdas
authors.forename: Samsun
authors.initials: S
authors.lastname: Lampotang
mesh_terms: D000328:Adult; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling; D004867:Equipment Design; D005260:Female; D005431:Florida; D006760:Hospitalization; D006801:Humans; D008297:Male; D014546:Urinary Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*