Summary
A catheter can be defined as a flexible medical tube inserted by a doctor or nurse to a patient to empty the urinary bladder and collect the discharged urine in a drainage bag. The urinary catheter can be inserted into the patient in two ways: firstly, a catheter may be carefully slipped through a minor opening that is created of the lower tummy of the patient, or secondly, a urethral catheter can be inserted through the urethra and carry urine out of the bladder.
Urinary catheters are usually used when a person experiences difficulties in peeing naturally. The catheter remains in the patient’s bladder depending on its type and the type of condition the patient is suffering from. The use of catheters can cause significant consequences for the medical facilities that offer the service to their patients (Brunelli et al., 2018). The consequences primarily arise due to the subsequent effects that the catheters have on the patients. This research paper focuses on the effects of urinary catheters on facilities, an investigation that sheds light on the use of catheters.
Adverse Effects of Catheters on Medical Facilities
Increased need for intensive care of the patients using catheters
The patients that use urinary catheters require a lot of medical attention. The urinary catheter may burst, and therefore the medical personnel needs to do regular checks from time to time to ensure that the urinary catheters are in good condition. If the patient is using an indwelling catheter, the area where the catheter is positioned in the patient’s body needs to be sufficiently cleaned with soap and water.
The urinary catheter also needs to be cleaned thoroughly to keep it clear of any dirt. Nevertheless, the area around the indwelling catheter needs to be cleaned after every patient’s bowel movement to prevent any infection from developing and spreading in the patient’s body. If the patient is using a suprapubic catheter, the qualified medical personnel need to clean the opening of the patient’s belly and the tube using water and soap daily and then use a dry gauze as a cover.
The process of inserting a catheter into the urethra or through an opening in the patient’s lower stomach involves complex steps. Therefore, it is no doubt that the nurse or doctor in charge is under immense pressure to ensure that the procedure is successful and that no harm is caused to the patient. If the patient faces any danger due to the insertion of the catheter into the urethra, then the medical center will be liable (Brunelli et al., 2018). Based on the assessments done, the use of urinary catheters on patients admitted to medical facilities causes strain on the medical staff since the patient, and the catheter needs a lot of intensive care to ensure that the patient is safe and the catheter is clean and in an excellent working condition. It is also clear that the medical center takes full responsibility if any harm is caused to the patient due to the insertion of the catheter.
The risk attached to Catheter-Associated Urinary Tract Infections
Sometimes, there is a possibility of catheters remaining in the bladder of a patient for too long, which can advance the danger of getting a Cather-Associated Urinary Tract Infection. The medical facility is responsible for curing and managing the infection until the patient recovers. Catheter-Associated Urinary Tract Infections are created by microorganisms that enter and subsequently infect the patient’s urinary tract through the urinary catheter inserted through the urethra or the patient’s lower stomach (Brunelli et al., 2018). There are some factors that could lead to a patient developing a Catheter-Associated Urinary Tract Infection. They include urine from the drainage bag flowing back into the bladder, insufficient emptying of the drainage bag, contamination caused by bacteria due to movement of the bowel, and carelessness during catheter insertion. Catheter-Associated Urinary Tract infections can lead to the patient’s developing complications, including fever, catheter obstruction, chronic renal inflammation, and in worst scenarios, it could lead to death.
The medical personnel has to ensure that the catheter bags are leak-proof before inserting them through the urethra or lower tummy of the patient. They also have to ensure that the drainage bags are fully emptied and positioned appropriately to avoid urine flowing back into the bladder of the patient. Therefore, the medical facilities need to apply top-notch mechanisms in the insertion of catheters and the subsequent care for them and the patients (Brunelli et al., 2018). If the medical facility fails to meet the necessary precautions, then the patients may develop Catheter-Associated Urinary Tract infections whose treatment is the responsibility of the medical facility. Factually, catheters cause intense pressure on the medical facilities.
Accumulation and Disposal of Catheters
Urinary catheters are mostly made of Polyvinyl Chloride plastic, rubber, and silicon. Catheter bags that have already been used need to be disposed. Therefore, the medical facility has to come up with an effective way of ensuring the disposal of the catheter bags. Catheters are mostly made of plastics which means they are biohazardous materials whose disposal can lead to health-related risks and impact the environment.
The careless disposal of urinary catheters can be harmful to the patients and staff of the medical facility. Used catheters contain microorganisms that may potentially lead to infections. Catheters are primarily disposed in the incinerators where they are burnt. The burning of plastic-made catheters releases harmful gases into the atmosphere, leading to air pollution. The careless disposal of untreated catheters could potentially lead to contamination of drinking and groundwater in the neighboring springs and streams of water. The inefficient incineration of catheters could generate harmful substances that could subsequently cause cancer and other adverse health conditions.
The accumulation and disposal of catheters constitute a significant concern for medical facilities. The facility has to ensure that the catheters are disposed of in the most effective way. The failure of medical facilities to follow specific health and environmental guidelines in the disposal of catheters could lead to the infection of its patients and workers and also cause significant pollution to its environment and the surroundings of the medical facility.
High Cost of the Catheters and its Associated Effects
The medical facilities incur significant expenses in the acquisition of catheters. Factually, there has been an increased number of patients in need of catheters. The patients include those who need medicine to be delivered directly into the bladder, those who need their bladder drained during childbirth, those who need assistance in passing urine since their bladder is weak, those who have obstructions in the urethra and need assistance to pass urine and those who are suffering from urinary incontinence.
Therefore, all these kinds of patients need assistance in passing urine which necessitates the use of catheters. The continued increase in the number of such patients requires that more catheters be bought by medical facilities (Dafaalla et al., 2022). Catheters are expensive, meaning that the medical facilities will have to incur the high cost leading to an increase in their expenditures. The aftermath is that more money will be allocated in the acquisition of catheters instead of the buying of other medical equipment such as X-ray scanners.
As discussed earlier, the use of catheters could lead to Catheter-Associated Urinary Tract infections. Medical facilities incur considerable expenses in the treatment of such infections. A review conducted on the cost attached to Catheter-Associated Urinary Tract infections in the United States of America in 2016 indicated that 10 197 U.S dollars were used in the medical care of intensive care unit patients (Dafaalla et al., 2022). 1,764 U.S dollars were used for the medical care of non-intensive care unit patients. 876 U.S dollars was used in medications and additional diagnostic tests by the medical facilities. 7 670 U.S dollars were used in the medical care of inpatients and outpatients. From this survey, it can be noted that CAUTIs have a significant economic impact on medical facilities.
The medical facilities also incur a high cost in ensuring clean and safe disposal of catheters. The facilities have to invest in expensive mechanisms to ensure that the disposal of catheters is both environmentally friendly and safe to the people in the surrounding. Nevertheless, patients who develop complications during the insertion of the catheters have to be hospitalized for a relatively long period of time (Dafaalla et al., 2022). The aftermath is that the hospital incurs costs related to the treatment and care of such patients. The medical facility has to provide food, medication, clothing, and a constant change of the catheter to the patient, causing a subsequent increase in the expenses of the facility.
Increased Abuse of Catheters in Medical Facilities
Most medical personnel, including doctors and nurses, use catheters for their recommended purpose, but some of them use the catheters for purposes they are not equipped for. Some of the inappropriate applications of catheters in medical facilities have led to significant problems in the medical field, especially in hospitals(Brunelli et al., 2018). Some doctors and nurses use catheters in the collection of urine for use in urine culture and diagnostic tests. The medical personnel mostly use indwelling urinary catheters for inappropriate purposes.
The misuse of indwelling urinary catheters has caused medical complications in the patients. The use of indwelling urinary catheters for a long time has led to the patients developing Catheter-Associated Urinary Tract infections and consequently increasing their stay in the hospital and the subsequent increase in the cost of keeping them in the medical facility (Brunelli et al., 2018). Nonetheless, the application of indwelling urinary catheters has shown a significant possibility of an increase in patients’ mortality.
Positive Effects of the use of Catheters
Although the use of urinary catheters has shown some significant disadvantages, their appropriate application has been a significant boost to the medication of patients admitted to the medical facility with urinary problems. The use of external or condom catheters has proved to be cost-effective, mainly because only the replaceable section or part of this type of catheter comes into contact with the body of the patient (Brunelli et al., 2018). The aftermath is that the medical facility will only incur the cost of buying the replaceable section while still maintaining the rest of the external catheter.
Condom catheters are of great importance to people who have a penis and have adverse mental disabilities (for example, dementia). The application of condom catheters has proved to be comfortable and pause a reduced risk of causing urinary infections (Brunelli et al., 2018). Some condom catheters are designed to be used for a long time before they are changed and replaced with others. The advantage of this feature is that they cause slight irritation to the patient’s skin.The use of intermittent catheters is of great advantage since they can only be used once and disposed. Therefore, the risk of the patient developing catheter-related complications is significantly reduced and hence ensuring the continued safety of the patient while also draining the bladder completely.
Catheters have had a significant application in helping outpatients who have difficulties in passing urine from the urinary bladder. If the urinary bladder is not appropriately and adequately emptied, urine may accumulate and build up in the bladder, which may result in an increase in the pressure in the kidneys. Factually, high pressure in the kidneys could subsequently lead to failure of the kidney and possibly cause permanent damage to the kidney. Therefore, the use of urinary catheters has significantly reduced the possibility of failure of the kidney and its damage. Additionally, catheters have been an enormous help in assisting patients with urinary problems to pass urine until they are able to pee naturally. Additionally, the use of catheter valves maintains the functions of the urinary bladder and its capacity.
References
Brunelli, S. M., Van Wyck, D. B., Njord, L., Ziebol, R. J., Lynch, L. E., & Killion, D. P. (2018). Cluster-randomized trial of devices to prevent catheter-related bloodstream infection. Journal of the American Society of Nephrology, 29(4), 1336-1343.
Dafaalla, M., Rashid, M., Sun, L., Quinn, T., Timmis, A., Wijeysundera, H.,… & Mamas, M. A. (2022). Impact of availability of catheter laboratory facilities on management and outcomes of acute myocardial infarction presenting with out of hospital cardiac arrest. Resuscitation, 170, 327-334.