Aims: A substantial proportion of patients residing in aged-care facilities require a urinary catheter. When problems arise with catheter care, a hospital transfer may be required which takes time, contributes to healthcare costs, and can place a great burden on patients and healthcare facilities. We aimed to assess emergency department (ED) presentations for uncomplicated catheter-related concerns from residential aged-care facilities, that may have been safely managed in the community.
Methods: We retrospectively reviewed ED presentations at a tertiary centre for male aged-care residents with catheter-related issues between 2018 to 2020. If the required management was a catheter flush, reinsertion or change, or catheter repositioning without balloon deflation, this was deemed suitable for community care.
Results: A total of 188 presentations were included with 118 urethral catheter related presentations and 70 suprapubic catheter related presentations. Main indications for transfer included blocked or bypassing catheters (46.8%), and dislodged or removed catheters (20.7%). Management in ED consisted of catheter change or reinsertion in 157 presentations, a small volume normal saline flush in 12 cases, or reassurance only in 14 presentations. In total, 165 presentations (87.8%) were suitable for discharge, and 23 (12.3%) required admission. We propose that a protocol for residential aged care facilities with red flags and simple techniques for catheter management, should be implemented to prevent unnecessary hospital transfers.
Conclusion: Transfer of residential aged-care patients to the emergency department is costly and burdensome. A protocol to identify and troubleshoot simple catheter-related presentations in aged care facilities may prevent ED presentations.