Preventing infection in elders with long-term indwelling urinary catheters.

PURPOSE: To explore selected factors related to the prevention of catheter-associated urinary tract infections (UTIs) in older adults.

DATA SOURCES: This review of the literature examined multiple studies regarding UTIs, and UTIs in relation to silver-tipped catheters, cranberry juice/extract, and the bacterial lysate Escherichia coli OM-89.

CONCLUSIONS: Silver-tipped catheters retarded the development of the biofilm. The use of cranberry juice/extract showed few if any adverse reactions and avoided the problems of induced antibiotic resistance or introduction to supra-infections, such as Clostridium difficile infection. The immune stimulant OM-89 shows promise and may lead to simple and inexpensive preventive measures. Further research is needed to include elders, both men and women, and elders with long-term indwelling catheters.

IMPLICATIONS FOR PRACTICE: Nurse practitioners (NPs) can assure that basic nursing principles regarding long-term indwelling catheter care are upheld, measures such as proper assessment and insertion, as well as the appropriate use of silver-tipped catheters. NPs can prescribe cranberry juice/extract and incur no apparent harm while possibly reducing infection rate. NPs must be aware of the dangers of administering prophylactic antibiotics that increase resistant microorganisms and can also increase susceptibility to C. difficile infection.