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Since urinary tract infections (UTI's) are one of the more common causes of delirium, it makes sense that preventing UTI's will reduce the incidence of delirium.
In turn, a common cause of UTIs in the hospital (and immediately post-discharge) is use of urinary catheters.
The literature shows that within 48 hours, all patients with indwelling urinary catheters have bacterial colonization of the bladder (REFs).
Moreover, newer information indicates the incidence of iatrogenic urinary infections in older hospitalized patients is XX% with catheters, while it is only x% without catheters.
FIND REFERENCES, INSERT.
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Limit your use of Foley catheters.
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Urinary catheters do have their place.
In certain patients, knowing the urine output every shift is important for management.
In others, skin care in the sacral and perineal area is so problematic that keeping the area dry is necessary.
There are also patients who have urinary retention for various reasons and require bladder catheterization.
And, there are patients who prefer urinary catheters for convenience because they are immobilized.
With these circumstances noted, we often find that the Foley catheter escapes our attention.
It is often placed in the Emergency Department, and with other priorities to address, the inpatient medical providers may overlook the need to remove it.
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Remove the bladder catheter as soon as you can.
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Generally, the reasons for the Foley are over-rated.
You can assess volume status by weighing the patient.
Skin care can be handled with diapers, barrier creams, and scheduled toileting.
Working with the nurses to find alternatives to Foley catheters will improve patient outcomes.
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Use weights to monitor volume status.
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Use toileting and barrier creams to manage incontinence.
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