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Nurses' and Physicians' Perceptions of Indwelling Urinary Catheter Practices and Culture in Their Institutions
Andrea Niederhauser1, Stephanie Züllig1, Jonas Marschall
1From the Swiss Patient Safety Foundation, Zurich.
Insights
Nurses generally hold more positive views than physicians regarding indwelling urinary catheter (IUC) use practices and culture. Addressing interprofessional perceptions is key for reducing IUC complications and improving patient care.
Area of Science:
- Healthcare Management
- Patient Safety
- Nursing and Medical Practice
Background:
- Indwelling urinary catheters (IUCs) are prevalent in acute care, posing risks of infection and complications.
- Effective IUC management requires shared understanding and responsibility between nurses and physicians.
- Variations in perceptions between these groups can impede efforts to reduce catheter use.
Purpose of the Study:
- To investigate and identify differences in perceptions of current practices and culture surrounding IUC use.
- To compare the views of nurses and physicians on IUC management and associated responsibilities.
Main Methods:
- A written survey was administered to 1579 nurses and physicians across seven Swiss hospitals.
- The survey assessed perceptions of institutional practices, culture, and responsibilities related to safe IUC use.
- Statistical analyses, including t tests and logistic regression, were employed to compare responses between groups.
Main Results:
- Nurses reported more positive perceptions of current IUC practices and culture than physicians.
- Significant differences emerged in views on avoiding unnecessary IUC placement and leadership commitment.
- Discrepancies were noted regarding shared values and attitudes supporting restrictive catheter use.
Conclusions:
- Indwelling urinary catheter management is an interprofessional domain requiring shared responsibility.
- Interventions aimed at improving IUC use must engage both nurses and physicians.
- Promoting awareness and communicating new standards should occur through interprofessional dialogue and formats.
Objectives:
Indwelling urinary catheters (IUCs) are commonly used devices in acute care that may lead to catheter-associated urinary tract infections or noninfectious complications. Responsibilities for IUC are usually shared between nurses and physicians, and a common mental model among the two professional groups is thus essential for a successful reduction in catheter use. The aim of this study was to determine variation in the perceptions of current practices and culture regarding IUC use between these two groups.
Methods:
Nurses and physicians (N = 1579) from seven Swiss hospitals completed a written survey on safe IUC use in their institution. The survey assessed participant's perceptions of current practices and culture in their institution, and their perceived responsibilities related to IUC care. t tests and logistic regression were used to examine differences in responses between physicians and nurses.
Results:
Nurses and physicians each have their own tasks but also share responsibilities for catheter placement, care, and removal. Overall, nurses were more positive than physicians about current practices and culture regarding IUC use within their institution (mean scale scores = 5.4 for nurses versus 5.1 for physicians, P < 0.001). Perceptions of the two professional groups diverged most strongly on practices to avoid unnecessary placement of IUCs, the presence of shared values and attitudes in support of restrictive catheter use, and the other group's leadership commitment.
Conclusions:
Indwelling urinary catheter management is a strong interprofessional domain and a shared responsibility. It is crucial that measures to raise awareness and to communicate new standards target both nurses and physicians and are discussed in interprofessional formats.
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