Awareness of urine flow in people with long-term urinary catheters

OBJECTIVES: The purpose of this study is to acquire knowledge about urine flow in relation to fluid intake and urinary output, catheter blockage, and urinary tract infection in people with long-term urinary catheters. DESIGN: This was a community-based exploratory and descriptive study. SETTING AND SUBJECTS: The research was conducted in the homes of participants, who were interviewed in North Carolina from October 2002 to June 2003. The sample included 21 males and 9 females, aged 23-96 years; almost half were members of minority groups. INSTRUMENTS: A urinary diary was used, including intake and output recordings and narrative data, as well as a semistructured interview schedule. METHODS: Three-day fluid intake and urinary diary data were collected, followed by face-to-face tape-recorded interviews in participants' homes related to catheter experiences and practices. Analysis of data involved descriptive statistics and content analysis of narrative data. RESULTS: Although urine flow frequently was disrupted by urinary sediment or kinks in tubing, urinary tract infection was significantly related only to traumatic catheter manipulations or catheter blockage. Catheter problems associated with urinary tract infection included: (1) "rough" catheter insertions, (2) "difficult" insertions, and (3) catheter blockage. CONCLUSION: Self-monitoring of urine flow may help prevent urinary tract infection episodes through careful attention to catheter position and by preventing blockage. Further study is needed to fully understand the role of fluid intake and determine what causes traumatic catheter insertions.