Objective: Urinary catheterization (UC) is a frequently utilized intervention in emergency departments (EDs) for bladder drainage, monitoring urinary output in critically ill patients, and facilitating patient care. The literature highlights that a significant proportion of UC applications are performed with inappropriate indications, with complication rates reaching up to 60%. Complications such as hematuria, urethral stricture, pyelonephritis, and catheter-associated urinary tract infections (CAUTI) pose substantial health concerns. This study examines the compliance of UC applications in EDs with Centers for Disease Control and Prevention (CDC) criteria, the complication rates, and the factors contributing to these complications.
Materials and Methods: This prospective observational study was conducted in a tertiary ED between September 1, 2019, and November 30, 2019. A total of 411 patients aged 18 and above who underwent UC were included. Patients’ demographic characteristics, comorbidities, indication compliance, and complications were recorded using a three-stage form. Appropriate and inappropriate indications were determined according to CDC criteria, and early and late complications were analyzed in detail.
Results: Of all UC applications, 61.3% were performed with appropriate indications, while 38.7% were conducted with inappropriate indications. Among appropriate indications, the most common reason was the need for critical care, whereas the most frequent inappropriate indication was the application to patients capable of collecting urine independently. Complications occurring within the first 24 hours were categorized as early complications, affecting 20.2% of patients. Late complications were observed in 24.9% of cases, with CAUTI identified as the infectious complication in 7.6% and non-infectious complications in 17.3% of cases.
Conclusion: Approximately 40% of UC applications in the ED were performed with inappropriate indications. Such inappropriate indications do not reduce complication rates; instead, they negatively impact patient safety and healthcare costs. Therefore, implementing educational programs, standardized protocols, and electronic alert systems for UC applications is recommended. These measures could enhance the quality of healthcare services by reducing complications and the rate of inappropriate UC use.