Urinary catheter fixation devices: an essential part of catheter management in the community.

Abstract

Within community, residential and nursing homes, urinary catheter fixation devices are usually used on an ad hoc basis. Adhesive tape is often used to secure and anchor an indwelling catheter in place, although some complications have been identified in the literature (see, for example, Bierman and Carignan, 2007) including: w Adhesive tape failing to adhere to external catheter surface w Tape loosening quickly and frequently w Cumbersome for patients to manage w Adhesive build-up, creating potential bacterial colonisation w May cause too much or not enough traction on catheter to stop movement w Skin integrity can be compromised (Hanchett, 2002). Although fixation devices have been identified as an important part of the management of indwelling urinary catheters by national guidelines (Royal College of Nursing (RCN), 2012; National Institute for Health and Care Excellence, 2012; Loveday et al, 2014), they are rarely used routinely. Health professionals are sometimes unaware of the different types of fixation devices and the benefits they can provide to patient care. The Wound, Ostomy and Continence Nurses Society (WOCN) (2012) specify the indications for use of these devices as follows: ‘to prevent the catheter or its retention balloon from exerting excessive force on the bladder neck or urethra’. This principle is also supported by the Health Protection Surveillance Centre (2011) and NHS Quality Improvement Scotland (2004), who state that: ‘the catheter and attached drainage systems should be well supported in a comfortable position for the individual at catheter insertion to prevent complications’.