Guidelines Reduce Urinary Catheter Use in the Emergency Department

Catheter-acquired urinary tract infections are a target for increased scrutiny by the Centers for Medicare and Medicaid Services (CMS), which now considers this condition nonreimbursable. In addition, urinary catheters are uncomfortable for patients. A Detroit hospital developed institutional consensus guidelines for the placement of urinary catheters in the emergency department, and introduced the guidelines in a lecture to emergency physicians and resident staff. Indications for placement included intubation, unresponsiveness, and need for emergency pelvic ultrasound, emergency surgery, or output monitoring. Researchers assessed catheter use during several 5-day periods the year before and the year after the guidelines were implemented.

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