Designing and assessing a urethral catheter skills workshop for intern doctors in a university teaching hospital
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ORIGINAL ARTICLE
Designing and assessing a urethral catheter skills workshop for intern doctors in a university teaching hospital Aisling U. Nic an Ríogh 1
&
Clare O’Connell 1 & Peter E. Lonergan 1
&
Niall F. Davis 1
Received: 12 March 2020 / Accepted: 16 April 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background Urethral catheterisation (UC) is a frequently performed medical procedure and catheter-related injuries can lead to significant morbidity for patients. The aims of this study are to assess interns’ exposure to UC and to design, implement and assess a structured UC skills workshop for hospital interns. Methods A 10-item anonymous questionnaire on UC was distributed to interns in two university teaching hospitals. Respondents were invited to participate in a skills workshop. Teaching methods for correct UC technique included a lecture, a video tutorial and a simulated patient model. Participants’ catheter insertion skills were assessed using a 20-item OSCE checklist when the UC workshop concluded. Results In total, 40 interns completed the initial questionnaire of whom 26 (65%) had not received any dedicated catheter skills training prior to commencing internship. Fourteen (35%) were unsupervised during their first UC. Fifteen (37%) interns attended the dedicated skills workshop. All interns found the workshop beneficial and 12 (80%) reported an improvement on confidence afterwards. Following the workshop, the mean (± standard deviation) catheter insertion OSCE score was 92% (± 14.1). Conclusions Interns have a lack of knowledge, experience and confidence with catheter insertion. Current training models are deficient. The introduction of a structured skills workshop may help to improve catheter insertion skills among interns. Keywords Education . Patient safety . Urethral catheterisation . Urology
Abbreviations AUA American Urological Association BAUS British Association of Urological Surgeons CAUTI catheter-associated urinary tract infection OSCE objective structured clinical examination UC urethral catheterisation UTI urinary tract infection
Introduction Urethral catheterisation (UC) is a frequently performed medical procedure in hospitals with over 25% of hospitalised patients catheterised during their admission [1, 2]. Improper UC technique can result in significant patient morbidities such as pain, urinary tract infection, urethral injury, urethral strictures, * Aisling U. Nic an Ríogh [email protected] 1
Department of Urology, Beaumont Hospital, Dublin, Ireland
haematuria and failure of bladder decompression. The incidence of traumatic UC is approximately 6.7 per 1000 catheters inserted [3]. In 2006, the National Healthcare Safety Network (NHSN) Report in the United States showed that the incidence of catheter-associated urinary tract infections (CAUTI) was 3.1–7.5 per 1000 catheter insertions [4]. Although these incidence rates are relatively low; the overall number of iatrogenic catheter-related morbidity is high due to the frequency of catheter use. Such complicati
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