Table 3.
Summary of secondary outcomes
| Outcome | No. of Studies | Findings | Conclusion |
|---|---|---|---|
| Length of Hospitalization | 2 23,25 | FEUWD implementation increased median LOH.* | More data needed |
| Antibiotic Use | 3 23,25,26 | 2 studies found E. coli was the primary causative agent of UTIs in patients with IUCs and FEUWDs.*Another found no change in antibiotic prescribing patterns before and after FEUWD implementation. | More data needed |
| Skin Complications | 8 20,23,25,30,34,38,42,65 | 3 studies reported erythema and skin breakdown due to device firmness, high suction, or allergic reaction to device material. 1 study found that hospital-associated pressure injuries (HAPIs) nonsignificantly increased after FEUWD implementation.† Still, 3 other studies reported HAPIs were avoided or reduced following FEUWD implementation. Several studies reported no or minimal skin breakdown and reductions in incontinence-associated dermatitis. | FEUWDs slightly favored |
| Mobility-Related Complications | 2 23,25 | Cases of deep vein thrombosis and pulmonary embolism were reported following FEUWD implementation.* | More data needed |
| Patient and Nurse Satisfaction | 8 22,24,26,28,30,35,38,68 | Satisfaction was high. Studies indicated good patient and caregiver satisfaction with home, outpatient community, and hospice care use of PureWick. | FEUWDs are favored to IUCs |
| Urine Specimen Collection | 5 20,29,38,39,42 | There were several reports of successful urine diversion and input/output measurements. Validation studies confirmed good agreement between urine samples from normal voiding and PureWick collection for several analytes, including urine protein concentrations. Test strip analysis and automated analysis are recommended, but microscopy is not due to filtration of certain analytes. Because bacteria may grow in the collection chamber, FEUWDs are not recommended for urinalysis. | Little difference between FEUWDs and IUCs (depends on method) |
| Cost-Effectiveness | 6 30,38,49,51,52,57 | Analyses have shown potential savings associated with FEUWD use through the avoidance of toilet-related falls and reduction in time required for incontinence care. Individual institutions have also generated their own estimates of cost savings, ranging from $13,786 on a per-patient basis to $1 million per year at a large academic hospital due to reduced CAUTIs and Medicare fines. | Cost-neutral to cost-saving |
*
These studies failed to track temporal changes in IUC and FEUWD status, making it difficult to determine if outcomes were associated with IUC or FEUWD use.
†
HAPIs are multifactorial and may not be associated with urinary catheter use.