Management of urinary bladder function in Danish hospitals, nursing homes and home care

The purpose of this study was to determine the prevalence of the various devices used for bladder function management in Denmark and to assess the scope for the use of alternatives to the indwelling urethral catheter. Data were collected on 1581 hospital patients, 1341 nursing home residents and 743 patients receiving home care. The sample populations were characterized by age, sex and independence in the activities of daily living. The prevalence of indwelling catheters in the three groups of patients was 13.2%, 4.9% and 3.9%, respectively. The equivalent figures for condom drainage systems were 1.5%, 0.8% and 1.2%, and for napkins 10.1%, 52.1% and 34.1%. Comparison of the results from this survey with earlier data indicates that over the period 1980-1991 (during which efforts have been made in Denmark to restrict indwelling bladder catheterization and encourage the use of alternative devices) there has been a reduction in the prevalence of indwelling catheters in hospital medical wards from 13.7% to 6.6%. Examination of the reasons for catheterization revealed that the proportions of patients catheterized because of incontinence were 14% in hospitals, 31% in nursing homes and 33% in home care. There is clearly a need to continue the educational efforts to inform staff of the infection risks and complications associated with indwelling catheters and persuade them of the advantages of the alternative techniques for care of the incontinent patient.