Abstract and Introduction
Abstract
When only physicians are trained to insert Coudé catheters, there is an increased burden to both the patient and the providers. Training nurses for placement of Coudé catheters can improve care and allow for better use of health care resources.
Introduction
Approximately 24 million urinary catheters are purchased annually by hospitals in the United States annually (Kashefi, Messer, Barden, Sexton, & Parsons, 2008). With nearly 25% of hospitalized patients receiving an indwelling urinary catheter (to be referred to as catheter) (Saint & Lipsky, 1999), it is clear that urethral catheterization is a common procedure. Due to the shorter length of the female urethra, women are typically easier to catheterize. In men, the combination of a longer urethra, the prostate gland, and associated pathologies affecting these two structures increases the likelihood of abnormalities that make the process of catheterization more challenging.
Although the majority of catheter placements are straightforward, there are instances in which placement can be difficult, leading to complications. These can include urethral in juries; catheter-associated urinary tract infections; hematuria; false passages; urethral, rectal, or bladder perforations; meatal stenosis; Fournier's gangrene; and urethralrectal fistulas (Canales, Weiland, Reardon, & Monga, 2009; Igawa, Wyndaele, & Nishizawa, 2008; Radhakrishnan, Marsh, Sheikh, Johnson, & Greene, 2005). To reduce complications, providers are continually exploring ways to provide safe catheter placement. Use of a Coudé catheter is one way to address difficult catheterization, particularly in male patients with benign prostatic hyperplasia (BPH), and can be performed by nurses who have been educated on this procedure.