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Reducing urinary catheter related infections in care homes: a review of the literature

Although much guidance indicates that indwelling urinary catheters should only be used for the management of urinary retention and incontinence as a last resort, approximately 10% of care home residents have them, leading to increased risks of catheter associated infections and mortality. Catheterisation rates and subsequent infections can be reduced through more proactive management of incontinence and toileting, and removal of urinary catheters from residents discharged from hospital. Staffing in care homes should match residents' nursing and continence needs to allow this proactive approach. Audit of care home should and hospital discharge catheterisation rates, combined with feedback and staff training will raise awareness of the benefits of reducing catheterisation rates. Use of the Department of Health's Essential Steps to Safe, Clean Urinary Catheter Care (2006a) will also help to reduce catheter associated infections.