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Urethral catheter audit
1Alder Hey Children's Hospital, Edge Hill University, Liverpool.
Insights
This audit found significant gaps in pediatric urethral catheterization training and documentation. Improved education and standardized care pathways are needed for better patient outcomes.
Area of Science:
- Pediatric Nursing
- Urology
- Healthcare Quality Improvement
Background:
- Indwelling urethral catheterization in children is a common procedure with potential complications.
- Current practices in pediatric catheterization require evaluation to ensure optimal patient care and safety.
- A lack of standardized national guidelines necessitates local assessment of catheter care protocols.
Purpose of the Study:
- To audit current practices of indwelling urethral catheterization in a pediatric hospital.
- To assess the training and knowledge levels of nursing and medical staff regarding catheterization.
- To identify areas for improvement in pediatric catheter care documentation and procedures.
Main Methods:
- A retrospective audit of 47 pediatric patient records for catheter use over eight months.
- A questionnaire survey distributed to 384 nursing and 174 medical staff on training and knowledge.
- Comparison of practices against locally developed standards in the absence of national guidelines.
Main Results:
- Documentation of catheter duration was missing in 13% of cases.
- Both nursing and medical staff reported insufficient training and knowledge gaps.
- A majority of nurses performed catheterization infrequently, less than annually.
Conclusions:
- Novel educational strategies are essential to maintain pediatric catheterization skills.
- Enhanced documentation, including computerized care plans, is crucial for improving catheter care.
- Standardized protocols and ongoing training are recommended to address identified practice deficiencies.
Abstract:
An audit was undertaken in one children's hospital to evaluate practice relating to indwelling urethral catheterisation of children. The records of 47 patients admitted over an eight-month period were reviewed to obtain information regarding catheter use. A questionnaire was sent to 384 qualified nursing staff and 174 medical staff to identify what training they had received and their level of knowledge about catheterisation practice. In the absence of national guidelines for urethral catheter care, locally developed standards were used for comparison in the audit. Timing and location of catheter insertion were noted. Duration of catheterisation ranged from one to 38 days but in 13 per cent of cases it was not possible to identify duration because of lack of documentation. Both nursing and medical staff reported low levels of training and areas of limited understanding of practice. A majority of nursing staff had never catheterised a child or did so less than once a year. Novel approaches to education are required to maintain knowledge and skills in this area of practice. Documentation needs to improve and include the use of computerised care plans and catheter care pathways.
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