# Adherence to Evidence‐Based Guidelines and Implications When Designing Electronic Documentation for Urinary Catheters

## TL;DR

This study examines how well healthcare providers follow guidelines for urinary catheter care and documentation in Australian hospitals.

## Contribution

The study identifies gaps in clinical adherence and documentation practices for urinary catheter management in acute care settings.

## Key findings

- Only 40% average documentation compliance with best practice guidelines was observed.
- Clinical care compliance with best practices was 77%, but securement of catheters in ICU patients needs improvement.
- Use of documentation templates improved record quality, regardless of format.

## Abstract

The aim of this study was to investigate the point prevalence and the rate of adherence to evidence‐based guidelines for patients who had indwelling urinary catheters in three Australian acute care hospitals.

A cross‐sectional observational design was used.

A multisite cross‐sectional observational design was utilised in three acute hospitals across Australia. Data were collected from each site in a single day directly from observation of the patient, the bedside notes and medical records. The data collected included observations of clinical care and scrutiny of the documentation of the insertion details and catheter care using best practice guidelines.

Of the 1730 patients audited, 47% were female. The mean point prevalence of catheters in situ across three sites was 12.9%. Correct documentation compliance was reported to be, on average, 40%. Documentation was significantly better when a template was available to guide information recorded: this was regardless of whether it was hard copy or electronic. Overall, clinical care compliance with best practices was 77%. Of note for improvement was the fixing of the urinary catheter to the thigh in highly dependent patients.

It was identified that there is a need for improvement across all three sites: specifically regarding securement of the urinary catheter to the patient’s thigh within the ICU. In addition, it was identified that there is a need for documentation of the urine bag change in ward areas. Documentation may be improved by incorporating templates into healthcare documentation systems in the future. Further work is needed to ensure nurses are aware of the adverse effects of urinary catheters and thus, the need to adhere to best practice guidelines.

There has been no patient or public contribution.

We have adhered to the STROBE guidelines for reporting.