190 Catheterisation and its effects: observations from an acute hospital point prevalence study

Abstract

Abstract Background Catheterisation is associated with negative health outcomes most importantly a 2.8-fold increase in mortality. We examined the duration of and indications for urinary catheterisation insertion in all admission in a Model 3 hospital. Methods At a single timepoint data were gathered on all inpatients in the hospital, excluding the Emergency Department and the Intensive Care Unit. Biographical data, admission diagnosis, diagnoses of dementia, delirium and urinary incontinence, use of diuretics and urinary incontinence medications, toileting plans, continence care bundles and mobility status were gathered from medical and nursing documentation. Results 6% of the study population had indwelling catheters prior to admission. On the day of data collection 21% of patients were catheterised. 24% of these newly catheterised patients had a documented trial of void performed. Of the 31 patients who had been catheterised within the last 15 days, only 16% had a trial of void. 30% of the newly catheterised had been so for longer than 15 days, only 55% of whom had ever had a trial of void. Reviewing admission diagnoses, 20% of the newly catheterised had had a hip fracture, and 4% had another reasonable indication for catheterisation. Of the 32 patients that did have a trial of void during their admission, 47% had failed, and remained catheterised, 31% were continent and 22% were newly incontinent. 42% of patients who required assistance of two for mobility were catheterised and 60% of those hoist dependent were catheterised. Conclusion There was a high prevalence of catheterisation in our study population. Despite evidence that early removal of a catheter is beneficial for future continence, trials of void were uncommon. Only 1 in 4 newly catheterised patients had a clear and reasonable indication for catheterisation recorded in the medical or nursing notes. Dependent mobility was a predictor of catheter use.