The management of urinary catheters: compliance of practice in Danish hospitals, nursing homes and home care to national guidelines.

The compliance of practice to national guidelines on urethral catheter care has been examined. Questionnaires on the practices used with patients under their care were sent to 1350 nursing staff. Replies were received from 1153 individuals, 692 from hospitals, 345 from nursing homes and 116 from home care. While national guidelines stress the importance of maintaining a closed urine drainage system, the results revealed that 25.4% of respondents opened the drainage system to collect samples of urine for analysis, 57.9% to perform bladder washouts and 76% to change urine bags. 26% of respondents reported that they collected urine samples for routine bacteriological surveillance, a procedure considered unnecessary in the guidelines. 83% of staff reported that they washed their hands after emptying urine bags. Staff awareness of written guidelines for various aspects of catheter care ranged from 25-68% in hospitals, 27-45% in nursing homes and 7-17% in home care. A marginal costs analysis was performed to estimate the economic consequences of non-compliance to the national guidelines.