Implementation of an external female urinary catheter strategy on prevention of skin breakdown in acute care: A quality improvement study.

There was no control group receiving no external catheter, indwelling catheters or standard briefs and pads, so the observed skin breakdown rate cannot prove prevention. Randomization used a posted sequential order and bedside documentation, an honour system the authors say lacks precision and would not be acceptable in clinical trials. The project was approved as quality improvement with consent waived, and its stated focus was not a product comparison trial. Only selected incontinent women who could cooperate with care and had no obstruction, diarrhoea, skin breakdown at the application site or certain vaginal or uterine conditions were included. Usability and preference were inferred from duration and switching, not formally measured. Indwelling catheter use and CAUTI rates were unit-level before and after observations, not controlled comparisons. Some patients had missing outcome data, no documented catheter use, or used a different device than the randomized allocation device.

This research received no specific grant from any funding agency. The authors declared no payments or influence from a third-party source.

Do not conclude that external female urinary catheters prevent skin breakdown or reduce catheter-associated urinary tract infections. The study did not compare them with no catheter or standard incontinence care, and the infection-related rates changed in mixed directions across units.