A Comparison of Intermittent Urinary Catheter Flow Rates

Transcription

1 A Comparison of Intermittent Urinary Catheter Flow Rates Deborah McWilliams* MSN, RN, CPNP, Kathleen Carroll* BSN, RN, CNN, Kerrie Quenneville** MSN, RN, FNP-BC Children s Hospital of Michigan, Department of Urology*, Henry Ford Hospital, Vattikuti Urology Institute** Detroit, Michigan

2 Children s Hospital of Michigan CHM is a free standing, 232 bed pediatric teaching hospital in Detroit Urology Clinic cares for children with complex congenital & acquired conditions in the inpatient & ambulatory settings

3 Objectives Discuss factors that impact catheter flow rates Be able to educate patients and caregivers regarding appropriate expectations of catheter flow rate

4 Purpose of the Study This study is to determine if there is a relationship between urinary catheter intraluminal diameter (Fr size) and flow rate of catheterized urine.

5 Background It is a common belief among clinicians that urinary catheter flow rates increase as the Fr size increases. For patients who require clean intermittent catheterization (CIC) for bladder management, faster flow rates may result in less time spent on toileting. More efficient bladder emptying may increase patient satisfaction and improve quality of life (QOL).

6 Literature Review One study of 3 way catheter flow rates among varied catheter sizes and manufacturers demonstrated significantly faster flow when manually irrigating the drainage ports of #18 Fr and #20 Fr Rusch catheters when compared with other brands (Manikandan et al, 2009). None of the catheters demonstrated increased flow rates with increased Fr size when draining an artificial bladder. Intermittent urinary catheters and pediatric sizes were not included in the study.

7 Artificial bladder Methods 38 Mentor and LoFric catheters Coude and straight tip 16 inch catheters were tested. All other catheters were straight tipped. Flow rates were measured with a stopwatch and the mean was calculated for each catheter size and style.

8 Methods

9 Outcome Dependent variable was catheter flow rate Each catheter was compared with the other 37 catheters

10 Results Increased flow rates were demonstrated with each incremental catheter size increase, however, statistical significance was not noted until the 12 Fr was evaluated. Faster flow rates were associated with larger intraluminal diameter and catheter length. Comparison of flow rates with the short catheters (<16 inch) did not show a significant difference until reaching the 14 Fr catheters. Comparison of the long catheters (=16 inch) showed no significant difference until reaching the 16 Fr catheters. Comparison of short catheters to long showed significant difference starting at the 12 Fr size.

11 Discussion Catheter flow rates increased with catheter length and intraluminal diameter. Statistical significance was not demonstrated until the catheter size was increased to 12 Fr, however, the increased flow rate with larger catheter size may improve patient satisfaction. Faster catheter flow rate may increase patient adherence to a clean intermittent catheterization (CIC) regimen and maximize bladder health and quality of life.

12 Implications Awareness of catheter properties that may enhance urinary drainage can be used to individualize the catheter prescription for patients who perform CIC. Knowledge of catheter properties can aid in educating patients and caregivers regarding appropriate expectations of catheter flow rates.

13 Implications Future research is needed to: evaluate flow rates of catheters of multiple manufacturers test larger number of catheters compare flow rates between straight and coude tip catheters evaluate the impact of catheter flow rate on patient adherence to CIC and perceived QOL

14 Acknowledgements Dr. Yegappan Lakshmanan, MD, Chief, CHM Urology Dr. Jack S. Elder, MD Chief, Vattikuti Urology Institute, HFHS Hitomi Kobayashi, PhD, RN Director, Center for Excellence in Pediatric Nursing Ronald Thomas, PhD Biostatistician Laborie Medical Technologies Corporation

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