Best Practice for Indwelling Urinary Catheter Care: Improving Catheter Stabilization

Stabilization of indwelling urinary catheters is a component of best practice because catheters that are not stabilized may result in numerous complications.  Infections due to bladder irritation and urethral trauma; pain, agitation, hypertension and tachycardia due to catheter migration; catheter dislodgement and/or catheter related pressure ulcers represent the majority of these potential complications. 

A CQI project was undertaken over a 6-month period to determining how to increase the use of indwelling urinary catheter stabilization in an acute care setting.  During the initial phase of this project, staff education, unit based skin team leaders and accessibility to product resulted in a 66% increase in catheter stabilization.  However, information gathered indicated that 56% of the stabilizers were ineffective and did not remain secure. 

Therefore, a second phase of this project was undertaken to compare and contrast the features of 7 stabilization devices in order to obtain a product with a reliable wear time that did not leave a residue on the catheter.  Interestingly, unreliable stabilization can lead to adverse outcomes. Residue on the catheter is a potential medium for bacteria growth and multiple reapplications of stabilizing devices represents a poor utilization of resources. Team leaders trialed 7 stabilizers with either clamp or velcro (instead of adhesive) catheter holders.  Evaluations included: product usability, effectiveness, wear time, patient comfort, and effects on skin integrity.  Results indicated that all products were comfortable and easy to use, none of the products compromised the skin.  However, 88% of the staff liked the catheter holder method (4% did not like Velcro closures) and only one product stayed intact for an average of 72 hours.

This poster will provide a project report and recommendations.