Adherence to Evidence‐Based Guidelines and Implications When Designing Electronic Documentation for Urinary Catheters

Abstract

AimThe aim of this study was to investigate the point prevalence and the rate of adherence to evidence‐based guidelines for patients who had indwelling urinary catheters in three Australian acute care hospitals.DesignA cross‐sectional observational design was used.MethodsA multisite cross‐sectional observational design was utilised in three acute hospitals across Australia. Data were collected from each site in a single day directly from observation of the patient, the bedside notes and medical records. The data collected included observations of clinical care and scrutiny of the documentation of the insertion details and catheter care using best practice guidelines.ResultsOf the 1730 patients audited, 47% were female. The mean point prevalence of catheters in situ across three sites was 12.9%. Correct documentation compliance was reported to be, on average, 40%. Documentation was significantly better when a template was available to guide information recorded: this was regardless of whether it was hard copy or electronic. Overall, clinical care compliance with best practices was 77%. Of note for improvement was the fixing of the urinary catheter to the thigh in highly dependent patients.ConclusionIt was identified that there is a need for improvement across all three sites: specifically regarding securement of the urinary catheter to the patient’s thigh within the ICU. In addition, it was identified that there is a need for documentation of the urine bag change in ward areas. Documentation may be improved by incorporating templates into healthcare documentation systems in the future. Further work is needed to ensure nurses are aware of the adverse effects of urinary catheters and thus, the need to adhere to best practice guidelines.Patient or Public ContributionThere has been no patient or public contribution.Reporting MethodWe have adhered to the STROBE guidelines for reporting.