Abstract
The cost of urethral catheterisation injury (UCI) is significant, but the true incidence of patient care error is difficult to establish in the absence of specific hospital codes recording difficult urethral catheterisation (DUC) and UCI. For many years urologists are familiar passing a non-traumatic hydrophilic guidewire blindly into the bladder to aid urethral catheter insertion in difficult circumstances. However, so far, no purpose-built regulated medical device was available on the market and clinicians had to improvise. Urethrotech filled that gap and developed the Urethral Catheterisation Device (UCD®), which integrates a standard hydrophilic Nitinol guidewire into a 3-way 16F Silicone urethral catheter design to enable safe second-line urethral catheterisation when first-line catheterisation with a standard urethral catheter is unsuccessful. The safety and efficacy of UCD® catheterisation were evaluated in consecutive cohorts of men undergoing cardiac surgery and compared to the incidence of DUC and UCI with standard Foley catheterisation. A simple new Male Catheterisation Algorithm is proposed that can deliver a safe male urethral catheterisation treatment protocol for all clinical settings of healthcare services, which is easy to implement and integrate into standard catheterisation training programs to manage DUC and avoid UCI, empowering a frontline workforce to deliver better patient care.
Highlights
Urethral catheterisation is one of the commonest procedures performed both in the community and hospital setting
In the United States, nursing staff perform the majority of catheterisations for both male and female patients with well-established procedure guidelines with particular focus on reducing catheter-associated urinary tract infections (CAUTI’s)
Multiple catheterisation attempts are made, ranging from 1.6 to 3.2, before the patient is referred to Urology services causing significant urethral catheterisation injury (UCI) in 32% of men [2]
Summary
Urethral catheterisation is one of the commonest procedures performed both in the community and hospital setting. 25% of the patients admitted to hospital will have a catheter at some point during their stay [1] and 7%. In the United States, nursing staff perform the majority of catheterisations for both male and female patients with well-established procedure guidelines with particular focus on reducing catheter-associated urinary tract infections (CAUTI’s). Multiple catheterisation attempts are made, ranging from 1.6 to 3.2, before the patient is referred to Urology services causing significant urethral catheterisation injury (UCI) in 32% of men [2]. When DUC does occur, the catheterisation emergency can escalate out of control, leading to acute UCI with bleeding requiring hospital admission for more invasive specialist procedures. DUC can delay patient care with the risk of cancellation of other remaining
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