A mixed methods approach to understanding and improving urinary catheter use in primary care settings

: perspectives from key stakeholders and clinical interventions

Abstract

This thesis investigates urinary catheter use in primary care settings, employing a mixed-methods approach across four studies. The research aims to understand prevalence, indications, patient experiences, information needs, and interventions for preventing catheter-associated urinary tract infections (CAUTIs).

A questionnaire study in Northern Irish nursing homes revealed a 6.4% catheterisation prevalence, with urinary retention as the primary indication. It highlighted higher UTI rates in catheterised residents and issues with staff training and policy awareness.

Qualitative interviews with community-dwelling patients uncovered the physical, psychological, and social challenges of long-term catheter use. Participants reported complications ranging from UTIs to life-threatening conditions like sepsis. Many felt unprepared for life with a catheter due to inadequate information and support from healthcare professionals.

Analysis of online forum discussions identified specific information needs of catheter users and carers, including guidance on catheterisation procedures, complication management, and the value of peer support in online communities.

A systematic review of CAUTI prevention interventions in primary care settings found that clean intermittent catheterisation was as effective as sterile technique, multicomponent infection prevention programs reduced CAUTI incidence in nursing homes, and self-management education showed promise in reducing catheter blockages.

The thesis concludes with recommendations for improving catheter care, including enhanced user education and support, improved healthcare professional training, implementation of multicomponent CAUTI prevention interventions, integration of peer support into formal care pathways, addressing the psychosocial impact of catheter use, and promoting innovation in catheter design. These recommendations aim to improve the quality of life for individuals with long-term catheters and reduce the burden of catheter-associated complications in primary care settings.

Thesis is embargoed until 31st December 2028.

Date of Award	Dec 2024
Original language	English
Awarding Institution	Queen's University Belfast
Sponsors	Jerash University
Supervisor	Carole Parsons (Supervisor) & Colin McCoy (Supervisor)