133 Prospective Audit of Adherence to Current Guidelines for Urinary Catheterisation on a Dedicated Geriatric ward in a Tertiary Hospital

Abstract

Abstract Background A review of current practice in urinary catheterisation of geriatric patients on admission to hospital in respect of current HSE guidelines; looking at adherence to prescribed indications. Methods A consecutive sample of inpatients (age >65 years) were included from a geriatric ward in a tertiary hospital. Medical notes and admission pro-forma were reviewed. Relevant demographic and clinical information was extrapolated and analysed descriptively using the Statistical Package for the Social Sciences software. Results Data from thirty-one patients was included. Mean age of the cohort was 81.58 years (SD=6.67) and 51.6% (n=16) were female (SD=6.67). The primary reasons for admission were increased care needs (n=6, 19.4%), and collapse/weakness (n=6, 19.4%), thereafter stroke (n=4, 12.9%). Urinary catheters were inserted in 45.2% (n=14); for output monitoring (n=4, 28.57%), diuresis (n=4, 28.57%) and management of acute urinary retention (n=3, 21.42%). The insertion was warranted as per guidelines in only 42.85% (n=6); for urinary retention (n=3, 21.42%), sepsis/ICU (n=2, 14.28%) and at patient's request for comfort (n=1,7.14%). Urinary incontinence was present in 25.8% (n=8). This was found to be poorly documented in medical admission notes (n=2, 6.5%). Mean hospital admissions in the previous twelve months was 1.61 (SD=2.20) and mean urinary tract infection in the same timeframe was 1.00 (SD=1.57). Trial without catheter was unsuccessful in 3.2% (n=1). Healthcare associated infection was recorded in 6.5% of cases (n=2). Conclusion Although this audit represents a small cohort, the results demonstrate a high rate of urinary catheter insertion without adequate indication. This audit should be repeated using a larger sample size. Appropriate education at ward level and with admitting NCHDs about: appropriate catheterisation practice should be performed with a view to re-auditing subsequently. Update of current guidelines is warranted.