Assessing indwelling urinary catheter use among patients undergoing Surgery at Kigali University Teaching Hospital

Abstract

Background: Up to 86% of operated patients are candidates to routine indwelling urinary catheters (IUC). Studies revealed a high prevalence of Catheter-associated urinary tract infections (CAUTIs). CAUTIs are the 3rd most common post-operative infections. A little is known about CAUTIs and IUC use in Rwandan hospitals. Aim of the study To assess the use of indwelling urinary catheter among patients undergoing surgery at Kigali university teaching hospital. Methodology The study took place at Theatre of Kigali teaching hospital among patients admitted in Theatre for surgery. A quantitative cross-sectional study design was used. 207 patients were recruited. An observation checklist was used. Data was analyzed by using descriptive and inferential statistics. The ethical principles were respected. Results: Among 207 participants recruited for the study, 56.5% of them used IUC. The prevalence was significantly related to Female sex, age of 26-35 years, procedure such as Obstetrics and Gynecology, Laparotomy, urology and neurosurgery, major surgery, emergent surgery, Spinal anesthesia, and presence of physician order (P <0.001). The IUC were placed for appropriate indications (95.7%,) but only one IUC (0.9%) was removed before patient left PACU and 56.5% of participants with IUC in place were not having a documented removal instructions and especially cases of Laparotomy (73.3%), orthopedic surgery(100%), neurologic surgery(100%) and general surgery (100%). Conclusion IUC was not routinely used at CHUK theatre except some procedures such as Obstetrics and Gynecology, Laparotomy, urology & neurosurgery. It was used for appropriate indication but the excessive duration due to poor post-operative removal instruction was suspected. Recommendation Periodic audit of IUC use and CAUTIs for surveillance, formulation of procedure specific policies governing IUC use, further researches on the duration of postoperative IUC retention and associated factors among patients undergoing surgery.