This article will investigate the district nurse's role in managing urinary catheter blockages, looking at why people require long-term catheterisation and the causes of blockages and then reviewing treatment methods. Current practice will be critically analysed and compared to the most up to date research and literature to inform district nurses of best evidence-based practice in the hopes of improving service user outcomes and quality of life and reducing the impact this problem has upon district nursing services with regards to time and resources.
Historically, the word ‘catheter’ derives from Greece, meaning ‘to let or send down’. Urinary catheters date back as far as 3 000 BCE, and have been used for the relief of painful urinary retention. A variety of materials were used, including papyrus, straw and even hollow tops of onions (Urotoday, 2022). Frederick Foley designed the catheter known today back in 1935 when latex rubber became available, and little modification has been made to the original design to date (Holroyd, 2017).
Long-term catheter use forms a large proportion of district nursing caseloads. In 2017, there were an estimated 90 000 people living with long-term catheters in the UK (Gage et al, 2017; Nazarko, 2019), and this number is likely to have risen further since this time. Evans et al (2000) claim that the costs of long-term catheterisation and its associated complications cost the NHS approximately £10 000 per service user, per annum, bearing in mind these figures were approximated over two decades ago. Fernley et al (2015) discovered the costs to the NHS to be between £1-2.5 billion per annum. Furthermore, they argue that catheter complications are responsible for around 2100 deaths each year. Queensland Spinal Injuries Service (2020) agrees that implications on health services, with respect to time and resources, are costly and have a large impact upon the service user's quality of life.
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