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Long Term Care Article and Summary

This article studies the effectiveness of urinary catheter washout solutions. This topic is important to study because many people require long term urinary catheterization for various reasons, including urinary retention due to BPH, prostate tumor, reduced bladder contractility, and other conditions. These patients can often experience complications such as blockage, leakage and infection. These can reduce patient quality of life and increase the need for medical professional interventions. 

Here is a summary of the article:

The focus of the article is to compare different indwelling catheter washout methods to determine if one is better than another. Primary outcomes included objective measures of catheter associated urinary tract infection and catheter blockage. These were quantified by number of symptomatic/asymptomatic UTIs, numbers of catheters used per patient, length of time each catheter was in situ. Secondary outcomes included washout acceptability measures (such as patient discomfort/satisfaction) quality of life, complications/adverse effects and health economic outcomes. Seven studies with a total of 217 participants completing the trial were included. Patients were primarily from (3) USA, (2) UK, (1) Canada and (1) Finland. 

There was not  enough data providing reliable evidence about the benefit or harms of washout policies/ different washout solutions to determine their efficacy in preventing catheter blockage or other complications. This is because most of the trials included in this meta-analysis were small and had inadequate reporting. Because of the imprecise results, this study was not able to determine if washouts are helpful in reducing UTIs and decreasing the need for further medical intervention. The quality of evidence was low to very low. 

This study is important because it highlights the need for large randomized control trials to clarify this issue. There are increasing amounts of patients who rely on indwelling catheters, particularly in long term care settings. These patients would certainly benefit from high-quality evidence regarding the need for washout procedures, and the most effective solutions to use. Future studies should focus on washout versus no washout in terms of catheter blockage rates and UTIs. A health economic analysis associated with different washout procedures would also be important to study. These studies should use standardized methods for assessing these outcomes so that the results would be more consistent and able to be interpreted in a useful manner. 

Here is the article: