Maintenance of indwelling urinary catheters with a novel polyhexanide-based solution: user experience
Catheter-associated urinary tract infection (CAUTI) can significantly affect patients' quality of life and increase healthcare costs.
This study aimed to capture patients' and nurses' experience of catheter maintenance using a polyhexanide-based solution (PS) in everyday practice.
Retrospective analysis of data was collected for a product evaluation. PS was used twice a week for five weeks.
The study included 42 patients, 30 (71%) men and 12 women (29%). After five weeks of rinsing catheters with PS, nine patients reported no or decreased frequency of CAUTI, eight a better quality of life, eight reduced blockage, seven a decrease in odour and five fewer catheter changes. Three patients reported no benefit from PS use. Nurses reported that fewer visits were needed and consumption of disposables was lower.
User experiences suggest that, as a novel means of catheter maintenance, PS has the potential to reduce catheter-associated complications such as CAUTI, improve quality of life and reduce healthcare costs.
Bacteriuria develops rapidly in catheterised patients (3–10% daily incidence rate) and the majority of patients with long-term indwelling catheters are continuously bacteriuric (Stamm, 1998; Hooton et al, 2010; Nicolle, 2014; Brusch, 2017). Even when urinalysis has positive results, the majority of these patients remain asymptomatic (Nicolle, 2014). However, up to 30% of patients with catheter-associated bacteriuria will develop symptoms; the occurrence of both positive culture and symptoms is defined as catheter-associated urinary tract infection (CAUTI) (Stamm, 1998; Nicolle, 2014).
The signs and symptoms of CAUTI, such as foul odour from the urine, fever, malaise and abdominal pain, can be embarrassing, distressing and uncomfortable for the patient (Nicolle, 2014; Dalton and Maute, 2019). If the primary infection is not effectively treated, patients may develop bacteraemia, which can be serious and lead to significant morbidity and mortality (Stamm, 1998; Nicolle, 2014). In community care settings in both residential/care homes and people's own homes, the risk of bacteraemia is much greater than it is in acute settings (Nicolle, 2014). CAUTI has been identified as the source of more than 50% of episodes of bacteraemia in long-term care facilities (Hooton et al, 2010; Fortin et al, 2012). Escherichia coli bacteraemia rates have increased by 24.3% between 2012 and 2016, with three-quarters defined as community onset (Bou-Antoun et al, 2016; Public Health England, 2017).
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