Use and management of chronic urinary catheters in long-term care: much controversy, little consensus.

In long-term care facilities, 5 to 15% of residents have chronic urinary catheters in place. Catheters are commonly used for urinary retention, incontinence control, wound management, and patient comfort. The appropriate use and management of these devices continues to be studied and debated. Transurethral catheters are more common than suprapubic or condom-type devices, but no method has been proven superior for use in long-term care. Although some catheter management and infection control measures are well supported in the medical literature, clinical practices still vary widely. The accurate diagnosis of urinary tract infection can be especially challenging in this population. Many aspects of catheter care remain to be clarified, and further research based in chronic care settings is needed.