Use of catheter maintenance solutions by community nursing staff: an assessment

A catheter is a flexible, hollow tube that is inserted into the bladder either via the urethra or via the abdomen (supra pubic) in order for urine to drain. It is kept in place with an attached balloon that is inflated using sterile water. It has been estimated that, in the UK, more than 90 000 people have a long-term catheter in situ (Gage et al, 2017). Catheters are rarely free of complications, and it is paramount that a thorough assessment be performed and all other options explored prior to their insertion. There are many problems that can occur as a result of catheterisation. Some of the more common ones are detailed below, and these rarely occur in isolation:

In 2014, the National Institute for Health and Care Excellence (NICE) produced guidelines for infection prevention and control, which recommended that an indwelling catheter should always be connected to a sterile closed urinary drainage system, and disconnection should be avoided unless it was clinically indicated (NICE, 2014). This is further supported by the epic3 guidelines (Loveday et al, 2014) for preventing CAUTIs and in the more recently updated guidelines published by NICE (2017).