Effectiveness of an External Urinary Device for Female Anatomy and Trends in Catheter-Associated Urinary Tract Infections.
Terrie Beeson, Joyce Pittman, Carmen R Davis
PMID 36867037WHAT IT FOUND
A female external urinary device diverted 85.5% of urine on average, and catheter use fell after introduction alongside catheter-removal protocols.
Urinary infection rates and skin irritation among incontinent patients also fell, but the study could not confirm those changes.
Key findings
01The device diverted 85.5% of urine on average; individual effectiveness ranged from 44.8% to 99.7%.
02Indwelling catheter use fell from 43.9% of patient-days in 2016 to 40.6% in 2018 and 36.6% in 2019.
03CAUTI rate was 1.34 per 1000 catheter-days in 2016 and 0.50 in 2019, and IAD prevalence among incontinent patients was 69.2% in 2016 and 39.1% in 2019, but neither difference was statistically significant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was not a randomised trial, so the before-and-after comparisons cannot prove the device caused the observed changes. Catheter and CAUTI reductions happened alongside a nurse-driven indwelling urinary catheter removal protocol and a quality focus on reducing catheter use, so the device's contribution cannot be separated. Urine volume data were incomplete for 7 of 50 patients. CAUTI and IAD differences were not statistically significant, and the low number of CAUTI events in 2019 may have limited the ability to detect a difference. Incontinence and IAD data came from only one month per year, and the before-and-after cohorts included both male and female patients rather than only women using the device. The study took place during the COVID-19 pandemic, which affected staffing, workload, and enrollment.
Declared interests
The authors declared that funding for the study and assistance with manuscript preparation were provided by Sage Products, a business unit of Stryker, the maker of the device.
The easy way to misread this
Do not conclude that the device was shown to reduce CAUTI or IAD. The CAUTI rate fell from 1.34 to 0.50 per 1000 catheter-days and IAD among incontinent patients fell from 69.2% to 39.1%, but neither difference was statistically significant, and catheter-removal protocols were also being used.