title: Inappropriate urinary catheter reinsertion in hospitalized older patients.
abstract: We investigated the incidence and rationale for inappropriate reinsertion of urinary catheters and elucidated whether reinsertion is an independent predictor of adverse outcomes.
  
  
  
  A longitudinal study was adopted. Patients aged ≥65 years with urinary catheters placed within 24 hours of hospitalization were enrolled. Data collection, including demographic variables and health conditions, was conducted within 48 hours after admission. Patients with catheters in place were followed-up every day. If the patient had catheter reinsertion, the reinsertion information was reviewed from medical records. Adverse outcomes were collected at discharge.
  
  
  
  A total of 321 patients were enrolled. Urinary catheters were reinserted in 66 patients (20.6%), with 95 reinsertions; 49.5% of catheter reinsertions were found to be inappropriate. "No evident reason for urinary catheter use" was the most common rationale for inappropriate reinsertion. Inappropriate reinsertion was found to be a significant predictor for prolonged length of hospital stay, development of catheter-associated urinary tract infections and catheter-related complications, and decline in activities of daily living.
  
  
  
  This study indicates a considerable percentage of inappropriate urinary catheter reinsertions in hospitalized older patients. Inappropriate reinsertion was significantly associated with worsening outcomes. Efforts to improve appropriateness of reinsertion and setting clinical policies for catheterization are necessary to reduce the high rate of inappropriate reinsertion.
authors.affiliation: Department of Nursing, National Cheng Kung University Hospital, Tainan City, Taiwan.
authors.forename: Fang-Wen
authors.initials: FW
authors.lastname: Hu
authors.affiliation: Department of Nursing, College of Medicine, Tzu Chi University, Hualien City, Taiwan.
authors.forename: Chuan-Hsiu
authors.initials: CH
authors.lastname: Tsai
authors.affiliation: Department of Health-Business Administration, Fooyin University, Kaohsiung City, Taiwan.
authors.forename: Huey-Shyan
authors.initials: HS
authors.lastname: Lin
authors.affiliation: Department of Nursing, College of Health Sciences, Chang Jung Christian University, Tainan City, Taiwan.
authors.forename: Ching-Huey
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan. Electronic address: charming.tw@hotmail.com.
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology*; D005260:Female; D006761:Hospitals; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000379:methods*
keywords: Aged; Outcomes; Urinary catheters