Urinary Catheter Securement May Influence the Safety and Comfort of Critically Ill Patients

Urinary catheter securement is a routine procedure in intensive care units (ICUs), but its importance often goes unnoticed compared with other aspects of critically ill patient care. A recent article published in Intensive & Critical Care Nursing, authored by Neus Calpe-Damians, a researcher with the Nursing Care research group at the Sant Pau Research Institute (IR Sant Pau), and Mireia Llauradó-Serra, a professor at the Faculty of Nursing of the University of Barcelona, reviews the available scientific evidence on this practice and proposes recommendations to improve safety, comfort, and quality of care.

Although urinary catheter securement is included in the recommendations of the main clinical guidelines, the review notes that many of them provide limited specific guidance and are not always adapted to the needs of critically ill patients. This lack of consensus can result in considerable variability in clinical practice and hinder the implementation of evidence-based strategies in intensive care units.

“Urinary catheter securement is often considered a secondary aspect of intensive care, but the available evidence indicates that it can directly influence the development of injuries, patient comfort, and safety during daily care,” Calpe-Damians explains.

An Everyday Practice With an Impact on the Critically Ill Patient’s Experience

Urinary catheters are frequently used in ICUs to accurately monitor urine output and facilitate certain aspects of care. However, their use may be associated with complications such as injuries to the urinary meatus, catheter-related discomfort, or device-associated urinary tract infections.

“Although urinary catheter securement is recommended in the main clinical guidelines, they provide little guidance on how it should be performed in critically ill patients. We aimed to review the available evidence to identify which factors may contribute to safer and more comfortable use of these devices,” Calpe-Damians notes.

The article examines studies published recently showing how proper catheter securement can help minimize accidental traction, reduce pressure on tissues, and improve patient comfort. It also reviews the available evidence on different securement methods and analyzes their advantages and limitations in the intensive care setting.

The review emphasizes that catheter securement should not be understood solely as a measure to prevent device displacement but as an intervention that may influence the patient’s experience and help prevent complications associated with its use.

Evidence Supports Strategies to Reduce Catheter-Associated Injuries and Discomfort

One of the main messages of the article is the importance of preserving skin integrity in critically ill patients. The severity of illness, the presence of edema, and certain circulatory disorders make these patients particularly vulnerable to skin injuries associated with the use of medical adhesives.

The review highlights the usefulness of preventive measures such as applying barrier products before placing securement devices, a strategy that may help protect the skin and reduce the risk of injury when adhesives are removed.

The article also analyzes the most appropriate location for securing the catheter. The available evidence suggests that the placement of the securement system may influence patient comfort and the development of certain device-associated complications. In this regard, “in many male patients, securement to the thigh helps maintain a more physiologic alignment of the catheter and reduce tension on the urethra, which could decrease the occurrence of injuries and discomfort associated with the device,” Calpe-Damians says.

Another aspect addressed is the frequency with which securement systems are replaced. Some studies indicate that extending replacement intervals, provided that the condition of the skin and the device is assessed regularly, could reduce the risk of skin injuries without compromising patient safety.

Improving Care Also Requires Reviewing Routine Procedures

Beyond the specific recommendations on urinary catheter securement, the article highlights the role of nursing research in the continuous improvement of care. Through critical reviews of scientific evidence, this type of publication helps identify opportunities to optimize procedures that form part of daily clinical practice and have a direct impact on the experience and safety of patients.

“Research in nursing care makes it possible to review procedures that establish part of daily clinical practice and generate evidence that supports safer decisions that are more closely centered on patients’ needs. Although these may seem like very specific issues, they have a direct impact on the quality of care,” Calpe-Damians emphasizes.

The review stresses that urinary catheter securement should not be regarded as a merely technical matter but as an intervention that requires consideration of factors such as skin integrity, each patient’s anatomical characteristics, mobilization needs, and the prevention of potential complications.

The article concludes that further studies are still needed to strengthen the available evidence and develop more specific recommendations for intensive care settings. Meanwhile, current knowledge can support progress toward safer and more personalized use of these devices, helping improve the quality of care in ICUs.

Reference Article:

Calpe-Damians N, Llaurado-Serra M. Current Insights on Urinary Catheter Securement Using Adhesives in ICU Patients. Intensive Crit Care Nurs 2026;95:104427. https://doi.org/10.1016/j.iccn.2026.104427.