Practices Related to Bladder Catheterisation Among Swedish Health Professionals: A Questionnaire Survey

Abstract

Bladder catheterisation is an invasive procedure that must adhere to precise guidelines established by authorities, hospitals or nursing associations to prevent or minimise associated complications. Research indicates that a significant portion of infections could be averted through dedicated periodic training, monitoring of adherence, optimising workloads and innovating in the development of products designed to mitigate risks or enhance ease of use. This study aims to explore the behaviour of nurses in Sweden concerning bladder catheterisation. An anonymous survey was distributed to groups of nurses in Swedish hospitals and healthcare centres. The survey was designed by an expert nurse team and was meticulously prepared and reviewed by a Swedish physician to ensure content validity, comprehension and clarity. A total of 910 nurses participated in the survey. When questioned about whether they are supervised for guidelines compliance when inserting a urinary catheter, 42.0% admitted to not doing so. In fact, only 9.3% of the respondents claimed that they always receive assistance from a colleague during the catheterisation procedure. Nearly 90% of the participants indicated that they could not consistently maintain sterility during catheter insertion, with the primary source of stress being time pressure during the procedure (21.3%). Among those surveyed, 70.4% acknowledged that, in their last 10 catheter insertions, they inadvertently spilt urine on materials at least once, while 27.7% reported spillage on the bedding and 16.5% on individuals. When asked about the potential advantages of a new catheter with an integrated valve, the most significant advantage cited was the reduced risk of urine leakage (63.0%), followed by the convenience of not having to connect a urine bag or plug (52.1%), and the improved ease of collecting urine samples (42.3%). Only 4.9% of respondents did not identify any potential advantages of this device. The correlation analysis showed an inverse relationship between both the level of stress and experience in bladder catheterisation (Spearman's correlation coefficient = -0.413, p value < 0.001) and the level of stress and the frequency of external help during the catheterisation process (Spearman's correlation coefficient = -0.265, p value < 0.001). The study's findings reveal a lack of supervision during catheterisation and the excessive workload or understaffing that often compels nurses to perform the procedure without the assistance of a colleague. These factors may underlie the insufficient adherence to guidelines and protocols, which can result in errors during insertion, thereby increasing the risk of non-aseptic insertion and occupational hazards. It appears essential to invest in organisational changes, provide continuous training for their staff and prioritise the development and innovation of new devices to aid healthcare workers in catheter management or addressing the issue of CAUTI from a multifactorial perspective.