Better strategies are needed so issues with long-term urinary catheters can be ”addressed and managed effectively” in the community, rather than accident and emergency, suggests a UK study.
Problems with long-term urinary catheters create a “considerable demand” on emergency departments and are very costly, warned the authors of the new study from South East London.
“Only 14% of patients actually saw a community nurse beforehand”
Li June Tay
Researchers from King’s College Hospital NHS Foundation Trust conducted an audit of patients presenting in A&E with problems associated with long-term urinary catheter use and assessed the availability of community nursing support.
In all, 78 patients with a urinary catheter problem presented to the trust’s A&E over a 69-day period, of 68% had a long-term catheter.
The average age of A&E attendees was 74 years and the average duration the catheter had been in place was 11 months.
Among the participants in the study, the most common reasons for attendance were found to be a blocked catheter (47%) and catheter-bypass (23%).
Only 36% were known to district nursing services, while 14% had been referred by a district nurse.
Catheter patients ‘need more district nurse support’
Most of the remainder self-referred to A&E and none of the patients in the study had any documented contact with their GP.
The researchers noted that 82% of the patients subsequently had their catheter issues “addressed adequately” by A&E nurses or doctors, without any specialist urology involvement.
“Most patients had minimal community nurse support,” said the researchers in the journal BJU International.
“More than 80% of patients attended the emergency department for a simple catheter problem, and only 14% actually saw a community nurse beforehand,” added lead study author Dr Li June Tay.