To what extent is education for urinary catheter insertion and management offered to registered nurses in the United Kingdom?

Abstract

Registered nurses (RNs) competent in catheter insertion and management reduce catheter days and catheter associated urinary tract infections (CAUTIs). Guidelines suggest that education in catheter insertion and management should occur regularly to ensure competency. However, there is no evidence to suggest this occurs in the United Kingdom. The databases Cinahl and Medline databases and the grey literature were searched and revealed that CAUTIs account for ~40% of hospital acquired infections and are associated with increased mortality, morbidity, length of stay and hospital costs. Prevalence, however, can be reduced if all evidence-based measures in insertion and management are carried out. The literature review demonstrated that clinical catheter related education improves nurses' knowledge which, translated into behaviour, results in reduced catheter days and CAUTI rates. A pragmatic, descriptive mixed methods convergent parallel approach was used to survey RNs from two professional associations through their mailing lists and social media platforms, using an online Qualtrics™ questionnaire. An online survey method was chosen to maximize geographical reach. Respondents confirmed their consent on accessing the online survey prior to commencing the questionnaire. All participants and their responses were anonymous. Results were saved on the Qualtrics™ platform and analysed quantitatively using descriptive statistics and qualitatively using a pragmatic approach to thematic analysis. Of the 72 responses, 61% (n = 44) worked in an acute hospital and 47% (n = 34) worked in the London area. There was representation from all over the United Kingdom except Scotland. 96% (n = 69) RNs were offered education in catheter insertion and management. Content of education included theory, practical, competency and ongoing education. 51% (n = 36) were offered education on a frequent basis. The results indicated that education in catheter insertion and management for RNs in the United Kingdom is not standardized. This may have implications for patient outcome measures such as CAUTI and on a macro level may be a symptom of wider organizational cultural inadequacies. Future research could inform the design of a standardized catheter insertion and management education package and measure its effect and impact on practice. The sampling method and subsequent response rate was a limitation of this study, and it may have been appropriate to use a more generic sampling frame to achieve representative results.