Introduction of the UroShield® in district nursing: a case study

This case study reviews a Quality Improvement (QI) project where the UroShield® device was introduced to patients with an indwelling urinary catheter (IUC) within a District Nursing Service (DNS) in New Zealand. Patients with IUCs often require more frequent interventions to maintain patency; however, best-practice guidelines state to avoid disruption to the sterile closed system as much as possible. The primary aim for the QI project was to improve patients’ quality of life (QoL) via reducing frequency of catheter-associated urinary tract infections (CAUTIs); reducing blockages and leakage; and improving overall comfort of the catheter, resulting in less catheter-related interventions. Secondary aims were to reduce costs to the service and organisation due to the use of less consumables; reduction in acute and planned nursing home visits for catheter management; reduction in the use of antibiotic therapy and risk of antibiotic-resistant colonisation; and removal of the financial burden of frequent General Practitioner (GP) appointments and prescription fees. The case study reviewed a small cohort of five patients who commenced UroShield® with analysis from 5 months pre- and post- UroShield® showing positive primary and secondary outcomes. There was an improvement in CAUTI and reduced prevalence of blockages, less nursing time required which positively impacted on the workload of the service, which in turn, led to cost savings for the organisation. The key recommendation arising from the QI project within the DNS, is that UroShield® be adopted as an option for appropriate IUC patients. A further randomised controlled trial is needed to examine the specific impact on QoL for patients within the cohort.