References
Catheters at home: managing urinary catheters in the home environment
Abstract
In England, there are some 90000 people with catheters in the community, and community nurses often have to manage catheter-related problems. This article looks at these common catheter problems found in the community, for example, blockage, infections and positioning problems. These problems were identified by a literature review and from the author's experience, from many years working in the community. It has been found that education, knowledge, empowerment and communication are vital factors affecting patients' ability to manager their catheters themselves. The article begins with a discussion about how patients can be involved in and manage many aspects of care for their own catheters. It goes on to talk about the common catheter-associated problems and how these can be avoided or addressed. It is hoped that better management of catheter-associated complications in the community settings can prevent unnecessary visits to the emergency department, which will save time and costs for the health service, as well as avoid the negative impact of these on patient lives.
Approximately 13% of all NHS patients are catheterised (Shackley et al, 2017), and, in England, there are 90 000 patients with long-term catheters in the community (Gage et al, 2017). Because of the high prevalence of catheterised patients on a district nurse team's caseload, catheterisation is an essential skill for all community nurses, no matter what shift patterns they work, and for many community nurses, catheter care can be a large part of their role. However, catheter management does not just have an impact on district nursing services. Ansell and Harari (2017) found that 49% of catheter patients went to the emergency department because of a blocked catheter, while O'Donohue et al (2010) found that 48% of patients with catheters visited the emergency department because of a urinary infection. These visits to the emergency department have an economic impact on the NHS, especially on emergency department services themselves, as well as the impact that this has on patients and their lives, especially when it involves a patient being discharged in the early hours of the morning. Many of these visits could be avoided with the better management of community-dwelling patients with catheters.
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