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Reducing the risk of infection in indwelling catheterisation

Caring for patients with indwelling catheters is common in nursing practice in all settings (Foxley, 2011), despite being the last resort for patients with long-term bladder control problems. Community nurses in particular will regularly encounter patients with indwelling catheters, ranging from those with nerve damage such as spina bifida, multiple sclerosis (MS), stroke or spinal injury; those with debilitating or terminal illness with loss of mobility; to those who may lack the cognitive ability or sufficient awareness to use the toilet. Catheterisation carries a high risk of infection, resulting in an increased burden of care and cost to healthcare providers. It can also negatively impact on patient wellbeing. Providing for these patients 'around the clock' can be a particular problem in the community, with carers and patients requiring education in how to manage both the catheters themselves, as well as the accompanying equipment at night. This article provides a background to long-term catheterisation, before looking at ways of preventing infection as well as the techniques and equipment that can better enable 24-hour care.