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Knowledge of Evidence‐Based Urinary Catheter Care Practice Recommendations Among Healthcare Workers in Nursing Homes
Authors:Lona Mody MD  MSc  Sanjay Saint MD  MPH  Andrzej Galecki MD  PhD  Shu Chen MS  Sarah L. Krein PhD  RN
Affiliation:1. From the Divisions of Geriatric Medicine;2. Geriatric Research, Education and Clinical Center and;3. Health Services Research and Development Center of Excellence, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan;4. General Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan;5. Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, Michigan.
Abstract:
OBJECTIVES: To assess the knowledge of recommended urinary catheter care practices among nursing home (NH) healthcare workers (HCWs) in southeast Michigan. DESIGN: Self‐administered survey. SETTING: Seven NHs in southeast Michigan. PARTICIPANTS: HCWs. MEASUREMENTS: The survey included questions about respondent characteristics and knowledge about indications, care, and personal hygiene pertaining to urinary catheters. The association between knowledge measures and occupation (nurses vs aides) was assessed using generalized estimating equations. RESULTS: Three hundred fifty‐six of 440 HCWs (81%) responded. More than 90% of HCWs were aware of measures such as cleaning around the catheter daily, glove use, and hand hygiene with catheter manipulation. They were less aware of research‐proven recommendations of not disconnecting the catheter from its bag (59% nurses, 30% aides, P<.001), not routinely irrigating the catheter (48% nurses, 8% aides, P<.001), and hand hygiene after casual contact (60% nurses, 69% aides, P=.07). HCWs were also unaware of recommendations regarding alcohol‐based hand rub (27% nurses and 32% aides with correct responses, P=.38). HCWs reported informal (e.g., nurse supervisors) and formal (in‐services) sources of knowledge about catheter care. CONCLUSION: Significant discrepancies remain between research‐proven recommendations pertaining to urinary catheter care and HCWs' knowledge. Nurses and aides differ in their knowledge of recommendations against harmful practices, such as disconnecting the catheter from the bag and routinely irrigating catheters. Further research should focus on strategies to enhance dissemination of proven infection control practices in NHs.
Keywords:urinary catheter  nursing homes  translating research into practice
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