We wanted to share the results of our survey completed by nurses caring for catheter patients. Firstly, a huge thank you; we had responses from over 150 nurses caring for over 2,500 catheter patients. More than simply hard numbers you have shared your experience of the reality of patients' care. Thanks also to the Nursing Times and their article and link to the survey, as the numbers really climbed in the days after that feature.
What have we learned? It has certainly confirmed the scale of the problems experienced; on average, close to 40% of catheters are found to block within 4 weeks, nearly 2/3 within 6 weeks and at least 90% within three months. Close to 50% of patients suffer bypassing and a similar level have needed antibiotics for CAUTI’s. We do though, see quite a variation in the levels reported, perhaps reflecting different local practices or patient characteristics? What is consistent is the concern expressed in the many examples you have given and the questions posed of us. Some of the themes that we have taken from this include;
· Suprapubic; many of you are concerned about supra-pubic catheters. The design of the Flume should be just as relevant for suprapubic as urethral use and we will ensure that we get approvals for both routes.
· Bypassing; While CAUTI’s and blockage are clearly a problem, bypassing appears to get typically less coverage and your scores and comments reinforce its significance as a concern for patients and carers. As a GP I had not realised just how big an issue it clearly is, so it is great that the Nursing Survey has brought this into sharp focus. We believe that the Flume design should have significant benefits here due to reduced encrustation and no exposed tip to be bent over, occluding the drainage eyes and thereby causing bypassing. At the same time we anticipate greatly reduced bladder spasms which are another primary cause. This is because the Flume is anticipated to irritate the bladder much less. It has half the device length internally than the Foley and it has a soft protective balloon over the tip quite different to the exposed Foley tip. We hope to be able to prove this in the proposed clinical trials and monitoring of patient quality of life measures
· Traumatic removal; A number of you highlighted the trauma caused when the catheter balloon is forcibly removed still inflated, perhaps by a patient with Alzheimers or with an accident snagging an insufficiently secured urine bag. This is very timely as we finalise the patient ready specification of the Flume.
The survey feedback has been invaluable as we finalise the design and prepare for ‘first in human’ clinical trials, that we hope to start early next year. More news in due course, not least as we hope to announce good news on the associated grant application.
John
