Long-term indwelling urinary catheter care: conceptualizing the research base

The traditional public health concepts of agent, host, and environment can provide a useful interdisciplinary model for analysing the current state of knowledge in long term indwelling urinary catheter care. A broad review of literature about urinary catheter care was carried out to identify major areas of research and gaps in knowledge. Most research in the past decade has focused on understanding how catheter encrustations develop and how such encrustations may contribute to leaking/blocking of the catheter and urinary tract infection. Two tables are presented which summarize research related to the development of sediment/encrustation of the catheter and to irrigation of the catheter. Nevertheless, many areas related to catheter care have not been studied extensively. The patient's perspective is one such area. Other areas that have not been studied in depth include care of the drainage bag and the role of fluid intake. These under-studied concerns relate to environmental factors with which the nurse is directly involved, namely, asepsis and hydrokinetic forces. Further conceptualization of the nursing role in long-term urinary catheter care might aid in the development of nursing theories that could be tested to understand how best to help people manage these catheters.