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Health Conditions Discover Plan Connect. Candidates Benefits Disadvantages Condom catheter kit Step-by-step instructions Maintenance Avoiding complications See a doctor For women Takeaway We include products we think are useful for our readers.
What are the benefits of a condom catheter? What are the disadvantages of a condom catheter? Share on Pinterest. How to put on a condom catheter. How to care for a condom catheter. Tips for avoiding complications. When to call a doctor. The same differences were seen for the combined measure of bacteriuria, symptomatic UTI, or death. A striking difference emerged when the mental status of the patient was taken into account.
For patients without dementia, indwelling catheter users were 4. For patients with dementia, this difference was not seen. In addition to being associated with a lower risk of infection, the condom catheters were much better liked than the indwelling ones, the study showed.
Based on this research, Saint concludes that "in patients who can get either a condom or an indwelling catheter and who are not cognitively impaired, they should receive a condom catheter — not only because it is likely to lower the risk of infection, but because it also appears to be more comfortable," he says.
Saint adds that while the findings are likely to help men, "We still need a better external catheter for women. The current one that is available requires so much adhesive it is not practical," he says. Meanwhile, the findings already have affected his decisions on the inpatient floors of the VA Ann Arbor Healthcare System. This includes men who have urinary incontinence and men who need to have their urine collected but are not critically ill. As for other facilities, Saint says that, where appropriate, clinicians should now consider the condom catheter.
This protection is especially apparent in men without dementia. Abstract Objectives: To compare condom and indwelling urinary catheters in terms of infection risk and patient satisfaction. Gov't Research Support, U. Patients on observation for 6- to 8-h period postprocedure when deemed appropriate observation for urinary retention. In order to more fully address widespread adoption of ECDs as an alternative to the indwelling catheter, a round-table discussion of clinicians with expertise in indwelling catheter management, prevention and treatment of CAUTI, and use of ECDs was convened.
The purpose of that meeting was to identify ECD knowledge gaps and indications for ECD use as an alternative to the indwelling urinary catheter. The expertise represented by this panel was broad and included 1 member with expertise in urology, 2 in quality improvement, 5 in infection prevention, and 1 in epidemiology. The expert panel met in Anaheim, California, on June 8, , to consider the current state of the science and evidence-based literature surrounding ECDs, and to identify knowledge gaps and indications for usage.
Each individual provided rationales and recommendations, and consensus on agenda topics was achieved. The agenda included 3 main topics: 1 urinary management and the impact on overall wellness; 2 current urinary management algorithms; 3 the benefits of implementation of male ECDs within a urinary management algorithm. They reviewed evidence-based literature on ECDs as an alternative for incontinence management prior to the round-table discussion.
A moderator guided the discussion, she was selected based on expertise in the process of consensus construction, and was an individual who was neutral to the topic. If consensus was not achieved after initial discussion, the statement was modified based on panel member input and a second, and sometimes third, consensus votes were taken until consensus was achieved.
Panel members recognized that current evidence demonstrates effective prevention of CAUTI primarily relies on a reduction in the number of indwelling urinary catheter days. Discussion then turned to the use of ECDs as an alternative for indwelling catheterization.
Panel members concurred that evidence concerning the efficacy of ECD as an alternative to the indwelling urinary catheter is sparse, especially when compared to the current focus on timely catheter removal protocols. Incorporating ECDs into discussions of CAUTI prevention, emphasizing the need to avoid unnecessary Foley catheters while maintaining the ability to capture accurate intake and output.
Ensuring adequate buy-in of clinical team members when introducing an ECD; addressing key stakeholders and team at correct time points; engaging medical director and nursing director, WOC nurses as stakeholders, nurse educators, and CAUTI prevention champions. Setting appropriate expectations regarding the learning curve for application of ECDs by nurses and presentation of the device as an evidence-based solution for CAUTI prevention; presenting the learning curve associated with ECDs as investment, which is part of the solution vs part of the problem.
Setting appropriate expectations regarding duration of ECD use and potential changes on a case-by-case basis; emphasizing evidence-based nursing.
Develop a customizable nurse-driven protocol for ECD usage in clinically appropriate situations. Develop tools to demonstrate value of ECDs cost avoidance. Collect patient survey information in ambulatory patients satisfaction, comfort, health-related quality of life to measure patient satisfaction.
Individual panel members observed that introduction of ECDs into their facilities sometimes met with resistance from nursing staff owing to concerns about application of an ECD, its ability to effectively contain urinary output, and prevention of potential complications such as urethral obstruction or local tissue damage if devices were applied too tightly.
Panel members with experience introducing ECDs in acute care facilities emphasized the need to set appropriate expectations regarding the learning curve required for application of ECDs by nurses, identifying indications for their use, appropriate application methods, expected wear time for a typical device, and anticipated duration for ECD use in acutely or critically ill patients.
Panel members also recognized the need for policies that allow individualization of ECD use based on patient needs, body habitus, and preferences. Several panel members reported improved staff acceptance of regular ECD use when they emphasized its role as an essential component of an evidence-based CAUTI prevention bundle, and when the associated learning curve was presented as an investment in the overall program's success.
Panel members who had introduced ECDs in their facilities also discussed the need to develop a nurse-driven protocol for their use based on standardized indications, and data collection documenting its impact on CAUTI occurrences and associated costs.
Nurse-driven protocols have been shown to be effective in empowering nurses to adhere to CAUTI prevention best practices. Based on their collective experiences, the panel concurred that ensuring adequate buy-in among clinical team members is essential when introducing regular use of ECDs as part of a CAUTI prevention bundle.
Recommended strategies included identifying and addressing key stakeholders and the team at strategic time points; and engaging support from key persons in administration such as the medical and nursing directors.
Panel members also advocated early involvement of key clinical leaders within the facility such as WOC nurses, nurse educators, and CAUTI prevention champions. Identification of unit-based CAUTI prevention champions or superusers of these devices is recommended, as these individuals are ideally situated to teach others to successfully apply and manage ECD as they gain experience in their use. Panel members practicing in ambulatory care settings also shared experiences regarding teaching patients and lay-caregivers on how to safely and effectively apply ECD, including setting expectations for a realistic learning curve, and a greater average wear time as skills applying these devices matured.
In addition to collecting data about the long-term effects of ECD use on UTI rates, they also advocated investigating data on the impact of these devices on satisfaction, comfort, and health-related quality of life.
The panel identified 3 aims for the literature review: 1 review evidence concerning the efficacy of ECD for prevention of CAUTI when compared to the indwelling urinary catheter, 2 review evidence concerning cost analyses associated with a CAUTI prevention bundle versus no formal program, and 3 identify knowledge gaps and prioritize research needs concerning use of ECD for prevention of CAUTI.
We queried the MEDLINE database using the following parameters: research in humans published within the last 10 years, English language, both sexes, adults aged 19 years and older. Given the limited amount of research in this area, the search included all levels of studies: systematic review with and without meta-analysis of pooled data, randomized clinical trials, nonrandomized trials, prospective cohort studies and retrospective case-control studies, multiple case series, and case studies.
The search also included best practice statements, clinical practice guidelines, comprehensive, and integrative reviews. MeSH terms queried were catheters; urinary catheterization; catheters, indwelling; cross infection; evidence-based nursing; and nursing assessment. Additional key words queried were condom catheters; penile sheath; nurse-driven protocols; CAUTI; prevention; and incontinence.
The literature review identified 86 potentially relevant articles. The editorial team then conducted a title review to eliminate duplicate articles, and articles unrelated to the stated aims, yielding 36 relevant titles. The editorial group then completed an abstract review of the 36 relevant articles, and 32 articles 1 , 2 , 5 , 7 , 19 , 21 — 23 , 25 , 26 , 28 , 29 , 31 , 32 , 34 — 50 were selected that were relevant and were read in full and used for the review.
One of the objectives of the focused scoping literature review was to identify clinical studies discussing the efficacy and safety of ECDs. Clinical trials that assess efficacy are sometimes called explanatory trials and are restricted to participants who fully co-operate. The study compared indwelling urinary catheters to ECDs in 75 men aged 40 years or more who required urinary drainage during hospitalization. Three case studies were published that focused on the safety of ECD use.
Ozkan and colleagues 48 reported isolated gangrene of the penis in a paraplegic patient, and Kawoosa 50 described penile strangulation and necrosis. In the first case study, 47 the necrosis was attributed to several factors, including lack of understanding regarding the impact of urine leakage and resultant skin damage, improper personal hygiene coupled with a neurogenic bowel, and an impaired immune system. Based on these findings, the authors discussed the importance of patient and caregiver education for appropriate application, and care of an ECD in the treatment of incontinence.
In the second and third case studies, 48 , 50 adverse outcomes were attributed to improper application of the ECD; these findings highlight the importance of proper application and patient observation.
Considered collectively, these case studies illustrate the importance of appropriate application of the ECD and adherence with proper care and hygiene. Collectively, these studies suggest that the cost associated with an effective CAUTI prevention program is less than the cost of anticipated infections in the absence of an effective prevention program is instituted.
There is a significant paucity of evidence-based literature associated with ECD indications and usage. Future research should include well-designed comparative effectiveness studies to compare ECDs with indwelling urinary catheters, assessing efficacy, safety, costs, patient satisfaction, and health-related quality of life.
Evidence-based guidelines should be developed to assist facilities with incorporating ECDs into CAUTI prevention bundles utilizing nurse-driven protocols. This expert consensus round-table meeting resulted in a clinically meaningful discussion regarding the promotion of widespread adoption of ECDs as an alternative to the indwelling catheter.
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