Aim
To improve patient care, particularly in rural and remote facilities, by upskilling emergency clinicians to perform guidewire catheter insertion, decreasing reliance on patient retrievals or after-hours urology services.
Outcomes
improving patient care:
- reducing urethral trauma associated with repeatediIndwelling urinary catheter (IDC) attempts
- reducing the need to progress to more invasive procedures e.g., Supra Pubic Catheterisation (SPC)
- reduced need for transfer to larger facilities, enabling the provision of care on or closer to country
- improved equity of care by providing rural and remote patients access to care that would be readily provided in tertiary hospitals
reduce health system costs:
- reduced costs for urgent retrievals associated with urinary retention
- reducing the need for urology call-ins for catheter insertions
- reduced patient length of stay via provision of more timely care.
Background
Indwelling urinary catheter (IDC) insertion is urgently required in the setting of a urological emergency such as acute, painful urinary retention. Difficulty in placing an IDC and repeated attempts can result in significant urethral or prostatic trauma and progressing to SPC insertion is a relatively invasive procedure.
Despite being used by urologists for many years, guidewire catheter insertion is a relatively simple procedure yet is not widely used by emergency clinicians, mainly due to a lack of awareness.
ED Staff Specialist Dr Katrina Starmer from Cairns Hospital ED developed and implemented an education package in liaison with Urology colleagues and the Cairns Emergency Medicine and Training (EMET) Hub Its integration into emergency practice has been demonstrated to improve patient care and significantly reduce retrieval costs.
