Identifying key factors that affect care home catheterisation rates: changing practice through audit

Urinary catheterisation in care homes is associated with increased morbidity and mortality. Catheterisation rates in English care homes can vary significantly, yet the cause of these variations remains unclear. The authors approached 114 randomly selected care homes (3,190 residents) in the health district of Gloucestershire, England. A postal questionnaire survey was used to determine the number of catheters per care home and where residents' catheters were first acquired. There was a wide range of urinary catheterisation prevalence between homes, with some homes having no catheterised residents and one home with a prevalence of 47%. The majority of care home residents acquired catheters as hospital in-patients (57%), prior to care home admission. The authors suggest that patients discharged from hospital with a urinary catheter need a catheter care plan stating the reason for catheter insertion, and plans for review and removal. There is a need for ongoing local audits in primary and secondary care to determine how many patients are being discharged with unnecessary urinary catheters.