Short‐Term Indwelling Catheters (A Systematic Review): Evidence for a Primarily Nursing Decision

<jats:title>ABSTRACT</jats:title><jats:p> <jats:bold>Program Overview:</jats:bold> 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.</jats:p><jats:p> <jats:bold>Methods:</jats:bold> 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).</jats:p><jats:p> <jats:bold>Results:</jats:bold> 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.</jats:p><jats:p> <jats:bold>Conclusions:</jats:bold> This review provides not only nurses and nurse managers, but also other health professionals with evidence of effectiveness to influence catheter choice.</jats:p>