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Supporting patients with long-term catheterisation to reduce risk of catheter-associated urinary tract infection

09 May 2019
Literature Review
02 May 2019
Volume 28 · Issue 9

Abstract

More than 90 000 of the UK adult population are estimated to have a urinary catheter, with 24% likely to develop symptoms of catheter-associated urinary tract infection (CAUTI). The consequences of having a CAUTI are reduced quality of life, risk of hospitalisation and increased mortality. The authors undertook a literature review of primary research studies to identify how nurses could support patients to maintain effective catheter care to reduce the risk of CAUTI. Four themes emerged: education, knowledge, empowerment and communication. The authors therefore conclude that consistent knowledge, clear communication and treating patients as partners in the decision-making process can help build trust and allow empower patients. This will enable patients to make safe and healthy decisions about their catheter, particularly with regard to personal hygiene and optimal fluid intake, to reducing the risk of CAUTI.

The use of indwelling urethral or suprapubic catheters is common and is not restricted to the hospital setting (NHS Improvement, 2018). The Health Protection Agency (HPA) (2012) suggested that catheters are frequently used in the community setting and usually left in place for at least 28 days. Gage et al (2016) estimated that in the UK more than 90 000 people have a long-term catheter. In many cases, patients have a catheter for neurological reasons (62.9%). According to the Chief Medical Officer, ‘urinary catheters are used relatively frequently in older patients as part of care in the management of conditions such as dementia, prostate disease and incontinence from other causes' (Department of Health (DH), 2013). However, long-term catheterisation is seldom trouble free, with most patients experiencing recurring problems, such as blockage of urinary flow and catheter-associated urinary tract infection (CAUTI) (Maeda et al, 2013; Wilde et al, 2013; Tay et al, 2016).

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Long-term catheterisation
Self-management
Catheter-associated urinary tract infections