| Abstract | Program Overview: Urinary tract infection is the most common infection acquired by patients in hospital. The major associated cause is the presence of indwelling urinary catheters. A variety of specialised urethral catheters have been specifically designed to reduce the risk of infection. These include antiseptic impregnated catheters and antibiotic impregnated catheters. Catheter choice or selection is primarily a nursing decision, and nurses also take a leading role in decision-making regarding catheters purchased for hospitals. Methods: A systematic review (including metanalyses) was completed with the Cochrane Incontinence Review Group. Eighteen studies met the inclusion criteria: antiseptic impregnated catheters versus standard catheters, which included silver oxide (n = 3 trials) and silver alloy (n = 8 trials), antibiotic impregnated catheters versus standard catheters (n = 1 trial), and comparisons of different types of standard catheters (n = 6 trials). Results: Silver oxide catheters were not found to prevent bacteriuria in short-term catheterised hospitalised adults (RR 0.87, 95% CI 0.68 to 1.13). Silver alloy catheters were found to significantly reduce the incidence of asymptomatic bacteriuria (RR 0.36, 95% CI 0.25 to 0.52.) in hospitalised adults catheterised for less than 1 week. At greater than 1-week catheterization, the risk of asymptomatic bacteriuria was still reduced with the use of silver alloy catheters (RR 0.67, 95% CI 0.50 to 0.90). The risk of symptomatic urinary tract infection was also found to be reduced with the use of silver alloy catheters (RR 0.60, 95% CI 0.50 to 0.73). Silver alloy indwelling catheters appear to reduce the risk of catheter-acquired urinary tract infection in hospitalised adults catheterised short term. Cost-benefit analyses indicate that compensation for increased cost of silver alloy catheters would come from the reduction in the cost of catheter-acquired urinary tract infection. Conclusions: This review provides not only nurses and nurse managers, but also other health professionals with evidence of effectiveness to influence catheter choice. |
| Authors | Jane Elizabeth Brosnahan, Bridie Kent
(Affiliation: Centre for Evidence Based Nursing Aotearoa, Auckland District Health Board, Auckland, New Zealand.)
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| Journal | Worldviews on evidence-based nursing / Sigma Theta Tau International, Honor Society of Nursing
(Worldviews Evid Based Nurs)
Vol. 1
Issue 4
Pg. 228
( 2004)
ISSN: 1545-102X United States |
| PMID | 17166156
(Publication Type: Journal Article)
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