A multicentre comparative evaluation of catheter valves

Urine-drainage leg bags: an overview

This article looks at leg bags from the perspective of the clinical guidance available, published research, review papers, the diverse nature of products available, and their use with catheters, sheaths or urinals. The part that leg bags play in catheter-associated urinary tract infection control is addressed. Other aspects of catheter safety are discussed, including the avoidance of catheter traction. Variations in leg-bag structure including bag size, inlet tubing, tap, connector and backing, along with the reasons for selecting a particular leg bag are considered, along with the choice of either leg-bag straps or sleeves. The article concludes that, as a result of the variation of leg bags available, patients may require assistance and support from health professionals in finding the right leg bag for them.

Catheter valves: a welcome alternative to leg bags

Catheterisation is commonly used to manage long-term bladder drainage. If intermittent catheterisation is not possible an indwelling urethral or suprapubic catheter will be used. There are a choice of drainage systems for use with indwelling urinary catheters including bed bags, link systems and catheter valves. Catheter valves are not suitable for everybody and patient assessment is vital: only patients with the cognitive ability and manual dexterity to operate a valve should be offered this option for bladder drainage. Catheter valves offer a number of advantages over drainage bags including improved privacy and dignity, prevention of bladder-neck trauma, reduced catheter encrustation and maintenance of normal detrusor muscle function. A number of catheter valves are available, including the EZ-Flow valve, and patient choice is important when selecting an appropriate product.

Offering patients a choice of urinary catheter drainage system

The aim of this article is to promote understanding of the benefits, assessment process and suitability of catheter valves, as a form of urinary drainage for patients. A literature review on the benefits of catheter valves provides the opportunity for an in-depth discussion that compares and contrasts different urinary drainage systems. On the evidence of the literature review, all patients require a holistic assessment which considers a number of factors, and provides the nurse with the essential objective data to ascertain the suitability of the catheter valve. These data can be transferred into an easy step-by-step algorithm to help guide the nurse in making the decision, with the patient, on the most appropriate urinary catheter drainage system.

Avoiding the pitfalls and perils of catheter care

Twelve per cent of hospital inpatients and 4% of community patients have an indwelling urinary catheter. Urinary catheterization increases morbidity threefold. The main hazards of catheterization are tissue damage, bladder damage, infection, encrustation and blockage. Obtaining informed consent before catheterization is extremely important. Restricting catheterization to those who clinically require this invasive procedure can reduce the number of people who are exposed to the hazards of catheterization. The use of silver-coated catheters can reduce the risk of infection and encrustation. Ensuring that practice is evidence-based further reduces the risks of catheterization.

Selecting a urinary catheter and drainage system

Selecting the most appropriate urinary catheter and drainage system is an important factor towards patient comfort. Inappropriate selection may introduce an array of unnecessary catheter-associated problems and discomfort for the patient. The author has found that nurses may be able to name or recognize catheters they use, but not other makes and models of similar products produced by other companies. Therefore, selecting a catheter and drainage system can be confusing due to the vast array of catheters, materials used and drainage systems available from various companies. Consideration should also be given as to when catheter care begins: before or following catheter insertion. This article is written to help in the selection of a urinary catheter and drainage system which is best suited for the patient.

Catheter valves for indwelling urinary catheters: a systematic review

This mini-review aimed to systematically review the evidence on the effect of catheter valves compared to free drainage into a bag for patients with indwelling urinary catheters. Data sources used were Medline, British Nursing Index, CINAHL, Ahmed, EMBASE, EBM Reviews, the Cochrane Library and reference lists of relevant papers. Papers considered were controlled trials comparing the use of a catheter valve with the catheter bag that were published as a full report, or detailed abstract (containing sufficient information to critique) in Dutch, German or English. Two studies with a total of 122 subjects were identified. The main outcome measures considered were reduction of incidence of bladder spasm and urinary tract infection (UTI) and patient preference. No statistically difference in the incidence of bladder spasm or UTI was demonstrated but patients showed a clear preference for the valve. Further research into catheter valves is needed, with larger study groups, which include housebound male and female patients, and longer follow-up period.

Catheter valves: a special focus on the Bard Flip-Flo catheter

This article examines catheter valves with a special focus on the Bard Flip-Flo. Catheter valves were first introduced into the UK in 1986. Ten years later, seven catheter valves were available of which three, including Flip-Flo, were available on prescription. Catheter valves are suitable for both males and females and both short- and long-term urethral or suprapubic catheters. Catheter valves can combine with urinary drainage bags to form link systems. The benefits of catheter valve usage, many of which are perceived but not well researched, include reduced urinary tract infection and maintenance of bladder tone and capacity. Current opinion indicates that patients with detrusor instability, impaired bladder sensation or confusion may find catheter valves unsuitable. Catheter care, including health education and monitoring, are required for catheter valve patients as well as conventional leg bag users. The Bard Flip-Flo catheter valve offers many benefits and is an established product within the UK.

Urinary catheters: selection, maintenance and nursing care

Catheterization is often undertaken without sufficient assessment, and the high rates of bacteriuria (10-20%) occurring in catheterized patients seem to be accepted (Ward et al, 1997). This article reviews catheter selection, maintenance and nursing care, highlighting problem areas and suggesting measures that may be taken to reduce the risk factors. A problem-solving approach, based on research evidence relating to catheter care, is presented. Often there is a simple solution to a problem, but treatments based on traditions or myths appear to be the first choice in many situations. This article aims to provide nurses with the evidence base required to establish and maintain a urinary drainage system safely.