A two phased study on health care professionals’ perceptions of single or multi-use of intermittent catheters

• Published in: International journal of nursing studies 2017-07, Vol.72, p.83-90
• Main Authors: McClurg, D., Coyle, J., Long, A., Moore, K., Cottenden, A., May, C., Fader, M.
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; Catheterization; Catheters - statistics & numerical data; Cleaning; Clinical medicine; Clinical outcomes; Continence advisers; Family physicians; Female; Health education; Health Personnel - psychology; Health promotion; Humans; Infections; Injuries; Intermittent; Intubation; Male; Medical personnel; Middle Aged; Multiple sclerosis; Nurses; Perceptions; Polls & surveys; Prescribing; Prescriptions; Primary care; Qualitative research; Quality of life; Self care; Spinal cord; Spinal cord injuries; Teaching; United Kingdom; Urinary tract infections
• ISSN: 0020-7489; 1873-491X
• DOI: 10.1016/j.ijnurstu.2017.04.009

This two phase study aimed to explore health care professionals’ teaching and prescribing practice related to intermittent catheterisation and to identify their perceptions about the possible implementation of a mixed (single and multi-use) package for intermittent catheterization. Single-use intermittent catheters are the norm in the UK although multi-use is common in some other countries. A recent Cochrane review found no difference in complications, including urinary tract infection rates, between those using single or multi-use catheters. A flexible option of both multi-use and single use intermittent catheters could provide users with more flexible choices in self-care. However, understanding health care professionals’ perspectives is one of the keys to developing a multi-use intervention. A qualitative research framework using in-depth interviews to inform an on line survey. In-depth interviews were conducted with health care professionals based in the UK who prescribe catheters, teach intermittent catheterisation or manage an intermittent catheterisation service. The interviewees were selected to represent a range of clinical areas, experience and professions − continence advisors, urology, multiple sclerosis (MS) and spinal cord injury specialist nurses, and General Practitioners. Following framework analysis the themes and factors identified were used to develop an on-line survey which was disseminated through health care professional networks whose members saw patients who use intermittent catheters. Nineteen health care professionals participated in the telephone interviews; 206 completed the survey. A wide range of professionals in terms of experience and specialty afforded rich information regarding the contextual issues around the teaching and prescribing of intermittent catheters. The primary finding was that health care professionals were concerned about ‘minimising health risk’ and maximising ‘normalcy’ for those using intermittent self-catheterisation. Health care professionals who worked in the acute setting or had no experience of re-use were most resistant to the re-use of catheters. Professionals requested evidence that a multi-use package would not increase the risk of developing a urinary tract infection or increase the burden of use to a patient before a mixed package would be considered. For multi-use to be acceptable, evidence based guidelines must be available for healthcare professionals and cleaning methods must be acceptable