# Knowledge and self-confidence of healthcare workers to perform transurethral catheterization: a matter deserving attention!

## TL;DR

Healthcare workers often lack confidence and knowledge in performing transurethral catheterization, highlighting the need for improved training.

## Contribution

This study reveals gaps in healthcare workers' confidence and knowledge in transurethral catheterization across different roles.

## Key findings

- 8% of participants lacked confidence, knowledge, or preparation skills for transurethral catheterization.
- Physicians and residents felt more confident in male catheterization compared to other roles.
- Training programs need reassessment to improve patient and professional safety during catheterization.

## Abstract

Patients may suffer from the sequela of complicated transurethral catheterization (TUC) such as urethral injury, infection, and stricture formation. We assessed the self-confidence, knowledge, and experience of healthcare professionals performing TUC.

A multi-center, prospective, cross-sectional questionnaire-based study was performed among healthcare workers from 5 university hospitals. Data was transferred to an online Data Management System and self-confidence, knowledge, and experience levels among different healthcare roles were compared.

Of all 747 participants, 8% did not feel confident, had enough knowledge or preparation skills regarding TUC. 23% never asked for help while performing TUC whereas 42% always asked for assistance (p < 0.0001).

Healthcare roles did not differ statistically in terms of TUC knowledge and understanding. However, healthcare workers in surgical specialties felt more confident in their knowledge (29% vs 21%).

Confidence in male catheterization skills rated as ‘well’ and ‘very well’ were reported highest by paramedics (71%, 20%) followed by nurses (48%, 20%), physicians (53%, 30%) and residents (50%, 36%).

In the event of difficult catheterizations, physicians mostly preferred the assistance of “urologists and urology residents” (64%) while nurses mostly reached out to other nurses (39%). Paramedics were the least likely to ask for assistance (40%) followed by nurses (26%), doctors (24%), and residents (13%) (p < 0.0001).

A significant proportion of healthcare workers do not have the necessary knowledge and understanding of TUC and do not feel confident in their catheterization and preparation skills when challenged by a difficult TUC, which requires the reassessment of the training programs pre- and post-graduation. This will facilitate and create a safer environment for both the patient and the healthcare professionals.

Trial registry: ClinicalTrials.gov NCT05334225

The online version contains supplementary material available at 10.1007/s00345-025-05677-3.