{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:07:54Z","timestamp":1780596474082,"version":"3.54.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Qingdao Municipal Health Commission","award":["2024-WJKY014"],"award-info":[{"award-number":["2024-WJKY014"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>This randomized controlled trial is aimed at evaluating whether external fixation of the urinary catheter to the body surface represents a low-value nursing intervention for patients undergoing transurethral resection of the prostate (TURP). A total of 208 patients who received indwelling urinary catheters after TURP in a tertiary hospital in Qingdao, China between June 2024 and May 2025 were randomly assigned to one of two groups: a nonexternal fixation group (n\u2009=\u2009103) and an external body surface fixation group (n\u2009=\u2009105). A between-group comparison of outcomes included postoperative hematuria, incidence of catheter-associated urinary tract infection (CAUTI), unplanned catheter removal, occurrence of urinary catheter-related meatal pressure injury (UCR-MPI), and associated economic costs. No significant differences were observed between the two groups in terms of postoperative hematuria or CAUTI incidence (P\u2009&gt;\u20090.05). Unplanned catheter removal did not occur in either group. However, UCR-MPI occurred significantly more frequently in the external fixation group (9 patients) than it did in the nonexternal fixation group (1 patient) (P\u2009&lt;\u20090.05). Additionally, the external fixation group incurred higher costs for personnel and consumables. External fixation of the urinary catheter to the body surface after TURP is associated with increased economic costs, reduced patient comfort, and a higher incidence of UCR-MPI, which indicates that it constitutes a low-value nursing practice. Nonexternal fixation appears to be a safe and effective alternative for post-TURP patients undergoing early mobilization.<\/jats:p>","DOI":"10.1371\/journal.pone.0350800","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:27:07Z","timestamp":1780594027000},"page":"e0350800","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Catheter body-surface fixation after transurethral prostate resection: A low-value nursing practice as evidenced in a randomized controlled trial"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0574-5389","authenticated-orcid":true,"given":"Yanan","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiying","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaiyun","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunpeng","family":"L\u00fc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4890-3305","authenticated-orcid":true,"given":"Haijing","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"issue":"10090","key":"pone.0350800.ref001","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0140-6736(16)32586-7","article-title":"Levers for addressing medical underuse and overuse: achieving high-value health care","volume":"390","author":"AG Elshaug","year":"2017","journal-title":"Lancet"},{"key":"pone.0350800.ref002","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/papr.13142","article-title":"Low-value care in musculoskeletal health care: is there a way forward?","volume":"22","author":"J Hartvigsen","year":"2022","journal-title":"Pain Pract"},{"issue":"10090","key":"pone.0350800.ref003","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/S0140-6736(16)32585-5","article-title":"Evidence for overuse of medical services around the world","volume":"390","author":"S Brownlee","year":"2017","journal-title":"Lancet"},{"issue":"1","key":"pone.0350800.ref004","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s12916-020-01563-4","article-title":"The three numbers you need to know about healthcare: the 60-30-10 challenge","volume":"18","author":"J Braithwaite","year":"2020","journal-title":"BMC Med"},{"issue":"15","key":"pone.0350800.ref005","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1001\/jama.2019.13978","article-title":"Waste in the US health care system: estimated costs and potential for savings","volume":"322","author":"WH Shrank","year":"2019","journal-title":"JAMA"},{"issue":"01","key":"pone.0350800.ref006","first-page":"32","article-title":"Establishment of a prediction model and preventive measures for bladder neck contracture after laparoscopic urethra-preserving prostatectomy","volume":"30","author":"ZP Li","year":"2024","journal-title":"Chinese Journal of Male Science"},{"issue":"8","key":"pone.0350800.ref007","doi-asserted-by":"crossref","first-page":"3000605231190763","DOI":"10.1177\/03000605231190763","article-title":"Comparison of holmium laser enucleation and transurethral resection of prostate in benign prostatic hyperplasia: a systematic review and meta-analysis","volume":"51","author":"F Chen","year":"2023","journal-title":"J Int Med Res"},{"issue":"6","key":"pone.0350800.ref008","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1097\/ASW.0000000000000157","article-title":"Urinary catheter-related meatal pressure injury risk factors in male critical care patients: a prospective repeated-measures study","volume":"37","author":"H Avci","year":"2024","journal-title":"Adv Skin Wound Care"},{"issue":"11","key":"pone.0350800.ref009","doi-asserted-by":"crossref","first-page":"26","DOI":"10.25270\/wmp.2021.11.2632","article-title":"Medical device-related pressure injury in an intensive care unit: a cross-sectional study","volume":"67","author":"IIC de Assis","year":"2021","journal-title":"Wound Manag Prev"},{"issue":"01","key":"pone.0350800.ref010","first-page":"1","article-title":"Chinese expert consensus and pathway management guidelines for accelerated rehabilitation surgery (2018 edition)","volume":"38","author":"L Chen","year":"2018","journal-title":"Chinese J Pract Surg"},{"issue":"6","key":"pone.0350800.ref011","first-page":"1","article-title":"Catheter-related urinary tract infection prevention and control best practices--one of a series of interpretations of the Expert Consensus on Best Nursing Practices for Catheter-Related Infection Prevention and Control","volume":"19","author":"PF Peng","year":"2019","journal-title":"Shanghai Nursing"},{"issue":"1","key":"pone.0350800.ref012","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13756-023-01254-8","article-title":"APSIC guide for prevention of catheter associated urinary tract infections (CAUTIs)","volume":"12","author":"ML Ling","year":"2023","journal-title":"Antimicrob Resist Infect Control"},{"issue":"6","key":"pone.0350800.ref013","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/bju.15406","article-title":"British Association of Urological Surgeons (BAUS) and Nurses (BAUN) consensus document: management of the complications of long-term indwelling catheters","volume":"128","author":"S Reid","year":"2021","journal-title":"BJU Int"},{"issue":"11","key":"pone.0350800.ref014","first-page":"1655","article-title":"Clinical practice of target management programme to reduce the incidence of catheter-associated urinary tract infection","volume":"56","author":"L Zhang","year":"2021","journal-title":"Zhonghua J Nurs"},{"issue":"04","key":"pone.0350800.ref015","first-page":"66","article-title":"Construction of a nursing low-value item list based on our clinical nursing practice guidelines","volume":"38","author":"YS Guan","year":"2023","journal-title":"J Nursing"},{"key":"pone.0350800.ref016","unstructured":"American Board of Internal Medicine. Choosing wisely. 2014. https:\/\/www.choosingwisely.org\/"},{"key":"pone.0350800.ref017","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ijnurstu.2018.07.002","article-title":"Low-value care in nursing: a systematic assessment of clinical practice guidelines","volume":"87","author":"EW Verkerk","year":"2018","journal-title":"Int J Nurs Stud"},{"key":"pone.0350800.ref018","unstructured":"Choosing Wisely Canada. Nine tests and treatment to question in nursing. 2024. https:\/\/choosingwiselycanada.org\/recommendation\/nursing\/#gerontology"},{"issue":"12","key":"pone.0350800.ref019","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1001\/jamainternmed.2015.5453","article-title":"Producing evidence to reduce low-value care","volume":"175","author":"DH Howard","year":"2015","journal-title":"JAMA Intern Med"},{"issue":"17","key":"pone.0350800.ref020","first-page":"2171","article-title":"Conceptual analysis of low-value care and current status of research","volume":"57","author":"JM Li","year":"2022","journal-title":"Chinese J Nurs"},{"issue":"17","key":"pone.0350800.ref021","first-page":"93","article-title":"Evidence-based nursing research on short-term indwelling urinary catheters in urological patients","volume":"35","author":"SH Yu","year":"2020","journal-title":"J Nurs"},{"issue":"8","key":"pone.0350800.ref022","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/AJN.0000000000000128","article-title":"Optimizing nurses\u2019 time: reducing assessment frequency in general care","volume":"125","author":"SP Chambers","year":"2025","journal-title":"Am J Nurs"},{"issue":"02","key":"pone.0350800.ref023","first-page":"207","article-title":"A study on the consistency test of a colour assessment tool for continuous bladder irrigation drainage","volume":"21","author":"ZZ Ma","year":"2021","journal-title":"China Nurs Manag"},{"issue":"4","key":"pone.0350800.ref024","doi-asserted-by":"crossref","first-page":"463","DOI":"10.18865\/ed.27.4.463","article-title":"Commentary: De-implementation Science: A Virtuous Cycle of Ceasing and Desisting Low-Value Care Before Implementing New High Value Care","volume":"27","author":"KW Davidson","year":"2017","journal-title":"Ethn Dis"},{"issue":"1","key":"pone.0350800.ref025","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s13756-023-01254-8","article-title":"APSIC guide for prevention of catheter associated urinary tract infections (CAUTIs)","volume":"12","author":"ML Ling","year":"2023","journal-title":"Antimicrob Resist Infect Control"},{"issue":"5","key":"pone.0350800.ref026","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1590\/S0104-11692012000500009","article-title":"Costs of most frequent nursing activities in highly dependent hospitalized patients","volume":"20","author":"AFC Lima","year":"2012","journal-title":"Rev Lat Am Enfermagem"},{"issue":"12","key":"pone.0350800.ref027","doi-asserted-by":"crossref","first-page":"5","DOI":"10.25270\/wmp.2022.12.59","article-title":"Medical device-related pressure injury due to urinary catheterization: a case report","volume":"68","author":"BK Woodmansee","year":"2022","journal-title":"Wound Manag Prev"},{"issue":"03","key":"pone.0350800.ref028","first-page":"1","article-title":"Expert consensus on the diagnosis and treatment of bladder neck contracture after benign prostatic hyperplasia","volume":"15","author":"WX Fu","year":"2023","journal-title":"Journal of Urology (Electron)"},{"issue":"6","key":"pone.0350800.ref029","first-page":"541","article-title":"Effect of different fixation sites of catheter on the prevention of mucosal pressure injury in stroke patients","volume":"35","author":"Y Zhang","year":"2018","journal-title":"J Pract Med"},{"issue":"5","key":"pone.0350800.ref030","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1002\/nau.24372","article-title":"Catheter-associated meatal pressure injury in hospitalized males","volume":"39","author":"C Shenhar","year":"2020","journal-title":"Neurourol Urodyn"},{"issue":"1","key":"pone.0350800.ref031","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1186\/s12913-020-05825-y","article-title":"How to assess the value of low-value care","volume":"20","author":"JA Sacrist\u00e1n","year":"2020","journal-title":"BMC Health Serv Res"},{"issue":"6","key":"pone.0350800.ref032","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/j.aucc.2023.02.005","article-title":"Incidence and risk factors for medical adhesive-related skin injury in catheters of critically ill patients: a prospective cohort study","volume":"36","author":"OP Frota","year":"2023","journal-title":"Aust Crit Care"},{"issue":"5","key":"pone.0350800.ref033","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1093\/jmp\/jht042","article-title":"\u201cChoosing wisely\u201d to reduce low-value care: a conceptual and ethical analysis","volume":"38","author":"JS Blumenthal-Barby","year":"2013","journal-title":"J Med Philos"},{"issue":"02","key":"pone.0350800.ref034","first-page":"202","article-title":"Effect of removal time of indwelling urinary catheter on near- and long-term complications after transurethral resection of the prostate","volume":"26","author":"XY Li","year":"2024","journal-title":"Chinese J Health Care Med"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0350800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:27:13Z","timestamp":1780594033000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0350800"}},"subtitle":[],"editor":[{"given":"Yashwanth","family":"Nanda Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":34,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0350800","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]}}}