Intervention to Reduce Catheter Complications in Older Patients

Vocabulary and key metrics from Hu et al. (2022) regarding a novel intervention to reduce complications from indwelling urethral catheters in elderly patients.

CAUTIs

Catheter-associated urinary tract infections, recognized as common adverse events that may lead to bacteraemia and death.

Noninfectious complications

Complications including pain or discomfort, bladder or kidney stones, paraphimosis, meatal erosion, and gross haematuria, which are found to be 5 times as common as infectious complications.

One-point restraint

A term used to describe indwelling urethral catheters because they may cause pressure injuries and a decline in activities of daily living (ADLs).

Quasi-experimental study

The study design adopted to compare a novel intervention against usual care in hospitalized patients aged $65$ and older.

Charlson Comorbidity Index (CCI)

An index indicating the number and severity of comorbidities with scores ranging from $0$ to $37$, where higher scores indicate more severe conditions.

Short Portable Mental Status Questionnaire (SPMSQ)

An assessment tool for cognitive function where impairment is defined as $2$ or more errors after adjusting for education level.

Geriatric Depression Scale Short-Form (GDS-SF)

A scale used to identify depressive symptoms in older patients, with a total score of more than $8$ indicating positive symptoms.

Katz ADL score

A measure of independence in activities of daily living using $6$ items (bathing, dressing, visiting the toilet, getting up, eating, and use of incontinence materials) with scores from $0–12$.

Postvoid residual volume (PVR)

The volume of urine left in the bladder after voiding; successful catheter removal is defined as $PVR \text{ } \boldsymbol{\beta} \text{ } 100\text{,ml}$ or a void-to-residual ratio of $> 2:1$.

Intermittent catheterization (IC)

A procedure applied based on PVR: $Q12H$ for $100–200\text{,ml}$, $Q8H$ for $200–300\text{,ml}$, and $Q6H$ for $> 300\text{,ml}$.

Valsalva manoeuvre or Crede’s method

Specific techniques mentioned as strategies to promote self-voiding after catheter removal.

Adjusted odds ratio (AOR) for noninfectious complications

A statistical result of $3.01$ (95\text{%} confidence interval: $1.32\text{--}6.81$) indicating the control group was more likely to develop these complications.

Adjusted odds ratio (AOR) for ADL decline

A statistical result of $11.20$ (95\text{%} confidence interval: $3.68\text{--}34.00$) showing the control group was significantly more likely to experience functional decline.

Protective constraint

A restraint glove used to prevent accidental catheter removal, most frequently cited in the control group (44.4\text{%}).