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January 15, 2003

Safety of Urinary Catheters

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(3):300-301. doi:10.1001/jama.289.3.300-a

To the Editor: In their article about patient safety, Dr Shojania and colleagues1 recommend the use of silver alloy and suprapubic urinary catheters. However, they do not address avoidance of unnecessary catheter use. Urinary catheters are widely and inappropriately used in hospitals; physicians are often unaware that their patients have a catheter in place, and such unrecognized catheter usage is particularly likely to be inappropriate.2 The Foley catheter has been derided as a "one-point restraint" that causes discomfort, poses an infectious risk, injures patients' dignity, and limits mobility.2 Shojania et al do not discuss catheter avoidance and removal as important ways to promote patient safety, despite the absence of confirmatory clinical trials.