Abstract
Introduction:
Inappropriate catheterisation poses a risk to orthogeriatric patients both in the pre-op and post-op phase. Introducing a foreign object increases the risk of infections, sepsis and seeding of infection to the newly implanted prosthetics for surgical neck of femur (NOF) fracture patients. Furthermore, catheterisation also increases the length of hospital stay and risks of bladder deconditioning and failed attempts at trial without catheter. Therefore, it is essential that nursing and medical staff are aware of the appropriate indications of catheterisation.
Method:
We retrospectively reviewed 40 patients within a one month period who were admitted to the orthogeriatric ward and underwent surgery for their NOF fracture. We examined whether catheterisation and indications were documented on the electronic patient records (EPR), we also reviewed where the catheterisation took place (e.g. on the ward or in the Emergency Department (ED)). Indications were compared to our hospital guidelines for catheterisation.
Results:
1 Patient had a long-term-catheter and was not used in the data analysis. Of the remaining 39 patients, 23 (60%) were catheterised. Majority of these cases (83%) were documented appropriately, with the most common indication being that of urinary retention (47%) especially in the post-op phase. However, 'NOF fracture/immobility' was the second most common documented indication (37%), majority of which (86%) were done in the ED prior to transfer to theatres/ward.
Conclusion:
NOF or immobility is not an automatic indication for catheterisation and catheterisation in these patients is not considered a routine pre-op measure for hip fracture surgery. More education needs to be done with the medical and nursing staff especially in the emergency department regarding this, including encouragement of use of other methods such as pads and bed-pans in the pre-op phase.