Andersen L, Bertelsen M, Buitenhuis V Maintenance of indwelling urinary catheters with a novel polyhexanide-based solution: user experience. Br J Nurs. 2020; 29:(18)S18-S28

Ashworth L. Challenges and opportunities: the role of the district nurse in influencing practice education. Br J Community Nurs. 2020; 25:(8)402-406

The unique knowing of district nurses in practice. 2015. (accessed 2 February 2022)

Bhandari TR, Shahi S, Mahaseth N. Massive encrustations as a consequence of longterm indwelling urethral catheter: a rare case report. Ann Med Surg (Lond). 2018; 34:14-16

Bier M. Re: strategy to control catheter encrustation with citrated drinks: a randomized crossover study. J Urol. 2010; 183:1390-1394

Burns J, McCoy CP, Irwin NJ. Weak organic acid synergy towards the prevention of catheter blockages. J Hosp Infect. 2021; 111:69-77

Davey G. Trouble shooting indwelling catheter problems in the community. J Community Nurs. 2015; 29:(4)67-74

Evans A, Pheby D, Painter D, Feneley R. The costs of long-term catheterization in the community. Br J Community Nurs. 2000; 5:(10)477-488

European Association of Urology Nurses. Evidence-based guidelines for best practice in urological health care: catheterisation – indwelling catheters in adults: urethral and suprapubic. 2012. (accessed 1 February 2022)

Feneley RC, Hopley IB, Wells PN. Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol. 2015; 39:(8)459-470

Gage H, Avery M, Flannery C, Williams P, Fader M. Community prevalence of long-term urinary catheters use in England. Neurourol Urodyn. 2017; 36:(2)293-296

Gibney LE. Blocked urinary catheters: can they be better managed?. Br J Nurs. 2016; 25:(15)828-33

Hagen S, Sinclair L, Cross S. Washout policies in long-term indwelling urinary catheterisation in adults. Cochrane Database Syst Rev. 2010; (3)

Health Protection Surveillance Centre. guidelines for the prevention of catheter-associated urinary tract infection. 2011.,12913,en.pdf (accessed 7 June 2022)

Holroyd S. A new solution for indwelling catheter encrustation and blockage. J Community Nurs. 2017; 31:(1)73-79

Holroyd S. Blocked urinary catheters: what can nurses do to improve management?. Br J Community Nurs. 2019; 24:(9)444-447

Jordan RPC, Malic S, Waters MG Development of an anti-microbial urinary catheter to inhibit urinary catheter encrustation. Microbial Discovery. 2015; 3:(1)

Keeping Urinary catheters from blocking. 2016. (accessed 27 April 2022)

Loveday HP, Wilson JA, Pratt RJ epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014; S1-70

Mackay WG, MacIntosh T, Kydd A Living with an indwelling urethral catheter in a community setting: Exploring triggers for unscheduled community nurse “out-of-hours” visits. J Clin Nurs. 2018; 27:(3-4)866-875

Maeda S, Takiuti T, Kohno Y Catheter blockage factors in patients cared for in their own home requiring long-term urinary catheterisation. International Journal of Urology Nursing. 2017; 11:(1)52-59

McCrory V. An overview of the role of the district nurse caring for individuals with complex needs. Br J Community Nurs. 2019; 24:(1)20-26

Managing catheters in the community. 2015. (accessed 2 February 2022)

National Institute for Clinical Excellence. Healthcare-associated infections: prevention and control in primary and community care. 2012. (accessed 2 February 2022)

Nazarko L. Preventing catheter-related problems in the community. Independent Nurse. 2019; (2)21-24

NHS England. Excellence in continence care: practical guidance for commissioners and leaders in health and social care. 2018. (accessed 7 June 2022)

Nursing and Midwifery Council. Standards for specialist education and practice: community nursing in the home/district nursing. 2001. (accessed 3 February 2022)

Pannek J, Vestweber AM. Klinischer Nutzen einer antimikrobiellen Blockerlösung bei Patienten mit Dauerkatheter [Clinical utility of an antimicrobial blocking solution in patients with an indwelling catheter].German2011

Paterson C, Dalziell R, Forshaw T, Turner A, Fraser G. Prevention and management of urinary catheter blockages in community settings. Nurs Stand. 2019;

Payne D. Catheters at home: managing urinary catheters in the home environment. Br J Community Nurs. 2021; 26:(8)370-376

Peate I. Closed and open catheter irrigation by a skilled and competent healthcare worker. British Journal of Healthcare Assistants. 2015; 9:(2)71-76

Queensland Spinal Cord Injuries Service. Preventing catheter blockages: a guide for healthcare professionals. 2020. (accessed 30 January 2022)

Queens Nursing Institute. The QNI/QNIS voluntary standards for district nurse education and practice. 2015. (accessed 2 February 2022)

Queens Nursing Institute. Untapped potential: district nursing services and the avoidance of unplanned admission to hospital. 2021. (accessed 2 February 2022)

Royal College of Nursing. Catheter care: RCN guidance for health care professionals. 2021. (accessed 30 January 2022)

Saint S, Kowalski CP, Forman J A multicenter qualitative study on preventing hospital-acquired urinary tract infection in US hospitals. Infect Control Hosp Epidemiol. 2008; 29:(4)333-341

Shaw C, Wagg A. Long-term urinary catheterisation in community-dwelling adults. Br J Community Nurs. 2019; 24:(6)258-262

Simpson P. Long-term urethral catheterisation: guidelines for community nurses. Br J Nurs. 2017; 26:(9)S22-S26

Stickler DJ. Clinical complications of urinary catheters caused by crystalline biofilms: something needs to be done. J Intern Med. 2014; 276:(2)120-129

Stickler DJ, Feneley RC. The encrustation and blockage of long-term indwelling bladder catheters: a way forward in prevention and control. Spinal Cord. 2010; 48:(11)784-790

Tay LJ, Lyons H, Karrouze I, Taylor C, Khan AA, Thompson PM. Impact of the lack of community urinary catheter care services on the emergency department. BJU Int. 2016; 118:(2)327-334

The Kings Fund. Understanding quality in district nursing services: learning from patients, carers and staff. 2016. (accessed 7 June 2022)

The Kings Fund. Waiting times for elective (non-urgent) treatment: referral to treatment (RTT). 2021. (accessed 2 February 2022)

Thompson T, Browne R. Elder care: a resource for interprofessional providers. Chronic urinary catheters – troubleshooting blockages.: The University of Arizona, College of Medicine, Tucson, Centre on Aging; 2019

Tremayne P. Managing complications associated with the use of indwelling urinary catheters. Nurs Stand. 2020; 35:(11)37-42

Urotoday. A brief history of urinary catheters. 2022. (accessed 8 February 2022)

Wang R, Neoh KG, Kang ET, Tambyah PA, Chiong E. Antifouling coating with controllable and sustained silver release for long-term inhibition of infection and encrustation in urinary catheters. J Biomed Mater Res B Appl Biomater. 2015; 103:(3)519-528

Wilde MH, McMahon JM, Crean HF, Brasch J. Exploring relationships of catheter-associated urinary tract infection and blockage in people with long-term indwelling urinary catheters. J Clin Nurs. 2017; 26:(17-18)2558-2571

Yates A. Indwelling urinary catheterisation: what is best practice?. Br J Nurs. 2016; 25:(9)S4-13

Young C, Thompson H. The role of the district nurse in Northern Ireland. Br J Community Nurs. 2018; 23:(7)328-333

The role of the district nurse in managing blocked urinary catheters

02 July 2022
13 min read
Volume 27 · Issue 7


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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