Urethral catheter audit

An audit was undertaken in one children's hospital to evaluate practice relating to indwelling urethral catheterisation of children. The records of 47 patients admitted over an eight-month period were reviewed to obtain information regarding catheter use. A questionnaire was sent to 384 qualified nursing staff and 174 medical staff to identify what training they had received and their level of knowledge about catheterisation practice. In the absence of national guidelines for urethral catheter care, locally developed standards were used for comparison in the audit. Timing and location of catheter insertion were noted. Duration of catheterisation ranged from one to 38 days but in 13 per cent of cases it was not possible to identify duration because of lack of documentation. Both nursing and medical staff reported low levels of training and areas of limited understanding of practice. A majority of nursing staff had never catheterised a child or did so less than once a year. Novel approaches to education are required to maintain knowledge and skills in this area of practice. Documentation needs to improve and include the use of computerised care plans and catheter care pathways.