Evidence for a nurse-led protocol for removing urinary catheters: A scoping review. Issue 1 (February 2023)

• Record Type: Journal Article
• Authors: Jones, Angela E; Nagle, Cate; Ahern, Tracey; Smyth, Wendy
• Is Part Of: Collegian. Volume 30:Issue 1(2023)
• Page Start: 190
• Page End: 197
• Publication Date: 2023-02
• Subjects: Urinary catheter -- Urinary tract infection -- Nurse-led; Nursing -- Australia -- Periodicals; 610.73099405
• DOI: 10.1016/j.colegn.2022.08.008
• Languages: English
• ISSNs: 1322-7696

Abstract

ABSTRACT: Background: Catheter-associated urinary tract infections significantly contribute to hospital acquired complications globally, with adverse implications for patient outcomes, healthcare, and fiscal resources. Nurse-led protocols for early removal of urinary catheters to reduce the incidence of catheter-associated urinary tract infections have been trialled. Aim: To report the evidence for nurse-led practices of removing urinary catheters within the acute healthcare setting. Methods: Five databases (CINAHL, MEDLINE, SCOPUS, EMCARE, and INFORMIT) were systematically searched in a scoping review of all peer reviewed publications up to 12/03/2021. Findings: Thirteen studies met the inclusion criteria. Eleven studies described a reduction in catheter-associated urinary tract infections regardless of the type of intervention, one study did not demonstrate a change and one study reported an increase in catheter-associated urinary tract infections. Settings, study duration and sample size varied substantially between the included studies. Interventions were exclusive nurse-led protocol for removal of urinary catheters, computerised reminder systems, bundle approaches or comprehensive packages. Outcome measures and definitions of catheter-associated urinary tract infections were varied or absent. Discussion: The quality of evidence of included studies in this review was low, attributed to by a number of methodological issues related to sample size and statistical analyses. Whilst the introduction of nurse-led protocols showed some improvements, the methodological inconsistencies make it difficult to highlight a specific protocol. Conclusion: Given the quality of existing evidence, caution is required in translating these findings to policy and practice.