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Nurses’ and Physicians’ Perceptions of Indwelling Urinary Catheter Practices and Culture in Their Institutions

Niederhauser, Andrea, MPH*; Züllig, Stephanie, PhD*; Marschall, Jonas, MD†‡; Schwappach, David LB, PhD progress! Safe Urinary Catheterization Collaboration Group

doi: 10.1097/PTS.0000000000000502
Original Article: PDF Only

Objectives Indwelling urinary catheters (IUCs) are commonly used devices in acute care that may lead to catheter-associated urinary tract infections or noninfectious complications. Responsibilities for IUC are usually shared between nurses and physicians, and a common mental model among the two professional groups is thus essential for a successful reduction in catheter use. The aim of this study was to determine variation in the perceptions of current practices and culture regarding IUC use between these two groups.

Methods Nurses and physicians (N = 1579) from seven Swiss hospitals completed a written survey on safe IUC use in their institution. The survey assessed participant's perceptions of current practices and culture in their institution, and their perceived responsibilities related to IUC care. t tests and logistic regression were used to examine differences in responses between physicians and nurses.

Results Nurses and physicians each have their own tasks but also share responsibilities for catheter placement, care, and removal. Overall, nurses were more positive than physicians about current practices and culture regarding IUC use within their institution (mean scale scores = 5.4 for nurses versus 5.1 for physicians, P < 0.001). Perceptions of the two professional groups diverged most strongly on practices to avoid unnecessary placement of IUCs, the presence of shared values and attitudes in support of restrictive catheter use, and the other group's leadership commitment.

Conclusions Indwelling urinary catheter management is a strong interprofessional domain and a shared responsibility. It is crucial that measures to raise awareness and to communicate new standards target both nurses and physicians and are discussed in interprofessional formats.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

From the *Swiss Patient Safety Foundation, Zurich;

Swissnoso National Center for Infection Control;

Department of Infectious Diseases, Bern University Hospital; and

§Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Correspondence: Andrea Niederhauser, MPH, Asylstrasse 77, 8032 Zurich, Switzerland (e-mail: niederhauser@patientensicherheit.ch).

This work was supported by a grant from the Swiss Federal Office of Public Health (no. 15.011083).

The authors disclose no conflict of interest.

progress! Safe urinary catheterization collaboration group:

• Adriana Degiorgi (Ente Ospedaliero Cantonale, Lugano Civico)

• Laura Esghani-Oswald (Spital Lachen)

• Stefan P. Kuster (University and University Hospital Zurich, Zurich, Switzerland)

• Hugo Sax (University and University Hospital Zurich, Zurich, Switzerland)

• Marianne Laguardia (Inselspital Universitätsspital Bern)

• Isabelle Montavon-Blondet (Hôpital neuchâtelois)

• Jasmin Perret (Kantonsspital Winterthur)

• Vineeta Bansal (Kantonsspital Winterthur)

• Anja Waltenspül (Luzerner Kantonsspital)

• Sonja Bertschy (Luzerner Kantonsspital)

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