Investigating patient experiences and healthcare providers' awareness of use of indwelling urinary catheters in hospital

Cross-sectional study: one observation per participant. This research project aims to (1) assess the patient experience of having an indwelling urinary catheter (IDC); and (2) identify any knowledge or practice gaps in healthcare provider awareness of IDC appropriateness at QEII Jubilee Hospital. Furthermore, this project seeks to evaluate the overall incidence of IDC-related complications from adverse events and/or infection at QEII Jubilee Hospital, captured in RiskMan and/or Auslab data. We aim to obtain a sample size of about 200 patient participants. The hospital has 190 inpatient beds, with approximately 25% having an IDC at any given time. Screening of the iEMR for patients with an IDC will be conducted Monday–Friday for one month. Patients can only be recruited once, regardless of the number of catheterisations. Inpatients with an IDC will first be identified via a daily report generated from the integrated electronic medical record (iEMR), and these patients will be approached individually to confirm the continued presence of an IDC. The investigator will introduce themselves as part of the study team (not the treating team), provide a participant information sheet, briefly explain the study aims and objectives, and seek the patient’s consent to participate in a questionnaire about their experience with the IDC. The patient will be given time (up to 30 minutes) to read the information sheet and ask any questions. If the patient agrees to participate, written consent will be obtained. If the patient declines to participate, no information will be collected. Questionnaire data will be collected on paper. The investigator will ask the patient 10 questions about the patient’s experience of having the IDC (Patient data collection form, v1.0, 20 August 2020). Patient age and gender will be collected. The last four numbers of the unit record number will be collected to enable matching of patient and healthcare provider feedback, but these will be removed from the data and destroyed once the matched data has been collected. No other identifying patient details will be collected. The patient questionnaire should take 5–10 minutes to complete over a single session. Next, the investigator will identify the healthcare providers (medical and/or nursing staff) with responsibility for the patient with the IDC. The investigator will separately interview each member of the patient’s medical team and nursing staff, as available. The investigator will explain the study aims and objectives to the provider, provide a participant information sheet, and seek their consent to participate in a questionnaire about the patient’s IDC. The healthcare provider will be given up to 5 minutes to read the information sheet and ask any questions. If the provider agrees to participate, written consent will be obtained. If the provider declines to participate, no information will be collected. Provider communication will occur on the same day as near as possible to the patient visit to ensure temporal congruence of findings. No patient care will be interrupted to facilitate this study. Questionnaire data will be collected on paper. The investigator will ask the healthcare provider 8 questions about the patient’s experience of having the IDC (Staff data collection form, v1.0, 20 August 2020). Provider category (medical/nursing) and role designation will be recorded, but no identifying personal details will be collected. Providers will not be allowed to view medical records or examine the patient during the questionnaire. If the provider is unsure of any responses, they will be offered the opportunity to further elaborate on any reasons for lack of IDC awareness. The health provider questionnaire should take 5 minutes to complete over a single session. Healthcare providers’ responses will be matched to the patient’s responses and iEMR documentation (date of IDC insertion; indication for IDC). Anonymous CAUTI data will be sourced from the hospital Infection Prevention and Management Service monthly report.