Nurses' perceptions of indwelling urinary catheters in older people

To explore nurses' perceptions about whether urinary continence is promoted for older people in acute medical and specialist medicine for the elderly care settings, or whether containment strategies are used.

A qualitative approach was adopted using five focus group interviews (n = 17) and four semi-structured single interviews (n = 4). Data were analysed thematically using the computer software package QSR NVivo 2.

Six themes emerged of which one was the use of indwelling urinary catheters. Nursing perceptions of and practice with their use varied between acute medical and specialist medicine for the elderly care settings. Whereas some decision-making lacked an underpinning evidence base or assessment, nurses' awareness about inappropriate catheterisation was increasing. Knowledge about the clinical input of continence nurse advisers was lacking and referral of patients to specialist services reduced with age.

A validated continence assessment tool specific to older people is required for documented evidence-based decision-making about the use of indwelling urinary catheters. Identified referral pathways are needed for equity of integrated continence services for older people.