Variations in indwelling urinary catheter use in four Australian acute care hospitals

Abstract

Aims and objectives To identify the point prevalence of indwelling urinary catheters (IDCs) in adult inpatients in acute care hospitals, and to describe the indications for IDC insertion based on patient age, gender, specialty and hospital. Background Catheter‐associated urinary tract infections (CAUTIs) are preventable healthcare‐associated infections. IDC duration is the strongest predictor of CAUTI, and little is known about characteristics of patients who receive an IDC. Design Two single‐day point prevalence surveys collected baseline patient data as part of a larger pre‐post control‐intervention study. Methods Surveys were conducted at four acute care hospitals in NSW, Australia, for all adult patients. Data collection included IDC presence, insertion details and urine culture collection. Point prevalence data were linked with electronically extracted patient demographic data. This study is presented in line with STROBE checklist (See Supplementary File 1). Result Data from 1,630 patients were analysed, with 196 patients (12%) identified as having an IDC on the survey dates. IDC prevalence rates were higher in males (13%) than in females (11%). Critical care had the highest rate of patients with IDCs (42%). Urine cultures were collected in 70 patients with an IDC (43%). Conclusions Findings indicated similar rates of IDC use in males and females, and there was no significant difference in age between patients with or without an IDC. However, indication for IDC varied by patient age and gender. High rates of urine culture collection may represent routine collection. Relevance to clinical practice IDC use is found across genders, all age groups and specialties. Nurses should be aware that any of their patients may have an IDC and be particularly aware of certain indications based on patient age and gender. Routine urine culture collection is not advised, and instead, nurses should be guided by clinical decision‐making tools.

Efficacy of Protocol of Hygienic Care by Chlorhexidine Gluconate on the Occurrence of Catheter Associated Urinary Tract Infection among Critical Ill Patients

“…The collected data were organized, tabulated and statistically analyzed using (24) who concluded that all patients with age >65 years old who were admitted in the emergency department during one-month period developed CAUTI…”

Bundle-of-care interventions to improve self-management of patients with urinary catheters: Study protocol

“…Nurses are the main providers of IDC patient education, however, little is known about nurses' understanding and awareness of the information their patients are accessing or information that may be readily available for patients ( Mackay et al, 2018 ). Recent studies identified the knowledge gap amongst nurses, especially in monitoring the ongoing need of IDC, and their unwillingness to remove the catheter as soon as it is no longer required ( Clinical Excellence Commission, 2013 ;De Jaeger, 2011 ;Giles et al, 2019 ). In addition, previous studies reported variability in nurses' knowledge levels and confidence in the decision-making process, in terms of the indication for an indwelling urinary catheter, inser-…”

“…The use of this digital information-sharing platform for patients has been shown to enhance patients' self-efficacy and self-care behaviours ( Campbell, Dunt, Fitzgerald, & Gordon, 2015 ). Another advantage of using this digital platform is the convenience and speed of delivering patient information ( Hebden et al, 2014 ), as most IDC insertions occur in acute inpatient settings ( Giles et al, 2019 ). Patients can repeatedly access this information using an application available to be sent to their smartphone, as an email, or short message service (SMS).…”

“…Insertion of IDCs are performed worldwide in hospital, community, clinic, and home-based settings, and a procedure most commonly performed by nurses. Globally, it is estimated that approximately 100 million urinary catheters are used annually ( Nasr, 2010 ), and the majority of these catheters are unplanned insertions in acute hospital settings ( Giles et al, 2019 ).…”

A Case of Traumatic Catheterisation leading to Rectal Perforation and Periprostatic Abscess

“…Although there is variation in the figures reported in the literature, it is estimated that approximately 25% of patients admitted to hospital have a urinary catheter during their inpatient stay [ 2 ]. A UK study performed in 2017 found that 18.6% of hospital inpatients had a urinary catheter at any one time [ 3 ]. Despite the relative ubiquity of catheterisation as an intervention, there are several complications associated with this process, including infection, trauma, malignancy, hypersensitivity, blockage, and fistula formation [ 4 , 5 ].…”