Difficult Urinary Catheterization (DUC) patients have a higher incidence of complications such as catheter associated urinary tract infections (CAUTI), urosepsis, incidental inflation of the balloon in the urethra and chronic stricture disease. This subset of patients require more future care and corrective surgeries. Many of these complications are caused by instrumentation of the urethra during the initial blind insertion. The Joint Commission, CDC and HICPAC agree that instrumentation of the urethra is the primary cause of urinary tract infections.
Real-time visualization of the urethra is the best way to avoid trauma and injuries and reduce the risk of CAUTI. Blind placement of a catheter is the fourth most painful procedure in the Emergency Department.
The National Quality Forum (NQF), a leading organization focused on patient safety, under Safe Practice 25: Catheter-Associated Urinary Tract Infection Prevention, recommends that progressive organizations use “direct visualization of the urethra during insertion of catheters, with the recognition that damage to the urethra can occur with blind insertions, leading to risk of infection.”
For more information on difficult urinary characterizations (DUCs), injuries to the urethra from catheterization and catheter associated urinary tract infections (CAUTI), see Clinical Resources.