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A questionnaire survey to understand the current status of managing indwelling urinary catheters in non-acute care settings and to investigate how catheter-associated urinary tract infections should be prevented in a care setting was conducted. The subjects included were as follows: 106 patients of the visiting nursing system (VNA), 146 of the special nursing home for the elderly (SNHFE), 77 of the geriatric health services facility (GHSF), and 130 of the long-term care bed (LTCB), in a Prefecture. We investigated the status of catheter management in compliance with each indicator in the Guideline for Prevention of Catheter-associated Urinary Tract Infections, 2009. The number of valid responses were 175 (ratio of valid responses, 38.1%), of which the usage rate of the indwelling urinary catheters were 10.5%, 3.5%, 3.8%, and 24.6%, in VNA, SNHFE, GHSF, and LTCB, respectively. The reasons for using catheters in VNA, other than medical use, included “burden reduction for caregiver” (19.5%) or “urinary incontinence care” (15.6%), whereas those for using catheters in LTCB were “bedsore treatment” (29.4%), “urinary retention and neuropathic bladder (24.7%),” and “terminal care” (14.1%). The usage rate of closed urinary drainage system in VNA, SNHFE, GHSF, and LTCB were 39.3%, 34.8%, 20.8%, and 28.3%, respectively. No difference was observed among the types of facility with respect to the status of complying with the guideline; however, the tendency of using sterilized gloves in the facility care was low. While choosing materials, such as a closed system, that are useful for preventing infection, there was a discrepancy between its necessity and usage rate. Thus, comprehensive managements, including improvement of catheter material or structure, and educational programs for preventing infections while considering the current situation of non-acute care are believed to be necessary.

Present Status and Challenges Concerning Urinary Catheters Left in the Bladder in Elderly Care Facilities and Home Medical Care