Foley catheter practices and knowledge among Minnesota physicians

Background: Urinary catheter use is common, and physicians are often unaware of the presence of a catheter in a patient. Despite this, and despite a recent policy change classifying catheter-associated urinary tract infection (CAUTI) as nonreimbursable, little is known regarding physicians' knowledge and attitudes regarding catheters, or their responses to the policy change. Methods: Licensed Minnesota physicians were sent an Internet-based survey regarding indications for Foley catheter placement, effectiveness of interventions for preventing CAUTI, and knowledge of and response to the changed reimbursement policy. Results: Overall, respondents exhibited good knowledge regarding indications for catheterization, with the 2 indications most widely accepted as being valid (critical illness with tenuous volume status and urinary obstruction) receiving the highest appropriateness scores. Most respondents reported awareness of the changed reimbursement policy for CAUTI; fully one-third indicated that because of this change, they now removed catheters earlier than previously. The responses from primary care physicians and surgeons differed significantly in terms of indications for catheterization, methods to prevent CAUTI, and the impact of the policy change on their practice patterns. Conclusion: Respondents demonstrated relatively good knowledge regarding Foley catheter use, and most were aware of the changed CAUTI reimbursement policy. Surgeons and primary care physicians may have different approaches to catheter management. Efforts are needed to translate catheter-related knowledge into good clinical practice.