Skip to main content

Designing and assessing a urethral catheter skills workshop for intern doctors in a university teaching hospital

Irish Journal of Medical Science (1971 -) volume 189, pages 1501–1506 (2020)Cite this article

Abstract

Background

Urethral catheterisation (UC) is a frequently performed medical procedure and catheter-related injuries can lead to significant morbidity for patients. The aims of this study are to assess interns’ exposure to UC and to design, implement and assess a structured UC skills workshop for hospital interns.

Methods

A 10-item anonymous questionnaire on UC was distributed to interns in two university teaching hospitals. Respondents were invited to participate in a skills workshop. Teaching methods for correct UC technique included a lecture, a video tutorial and a simulated patient model. Participants’ catheter insertion skills were assessed using a 20-item OSCE checklist when the UC workshop concluded.

Results

In total, 40 interns completed the initial questionnaire of whom 26 (65%) had not received any dedicated catheter skills training prior to commencing internship. Fourteen (35%) were unsupervised during their first UC. Fifteen (37%) interns attended the dedicated skills workshop. All interns found the workshop beneficial and 12 (80%) reported an improvement on confidence afterwards. Following the workshop, the mean (± standard deviation) catheter insertion OSCE score was 92% (± 14.1).

Conclusions

Interns have a lack of knowledge, experience and confidence with catheter insertion. Current training models are deficient. The introduction of a structured skills workshop may help to improve catheter insertion skills among interns.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

Abbreviations

AUA:

American Urological Association

BAUS:

British Association of Urological Surgeons

CAUTI:

catheter-associated urinary tract infection

OSCE:

objective structured clinical examination

UC:

urethral catheterisation

UTI:

urinary tract infection

References

  1. Gardner A, Mitchell B, Beckingham W, Fasugba O (2014) A point prevalence cross-sectional study of healthcare-associated urinary tract infections in six Australian hospitals. BMJ Open 4:1–9. https://doi.org/10.1136/bmjopen-2014-005099

    Article  Google Scholar 

  2. Weinstein JW, Mazon D, Pantelick E, Reagan-Cirincione P, Dembry LM, Hierholzer WJ Jr (1999) A decade of prevalence surveys in a tertiary-care center: trends in nosocomial infection rates, device utilization, and patient acuity. Infect Control Hosp Epidemiol 20:543–548. https://doi.org/10.1086/501675

    CAS  Article  PubMed  Google Scholar 

  3. Davis NF, Quinlan MR, Bhatt NR, Browne C, MacCraith E, Manecksha R, Walsh MT, Thornhill JA, Mulvin D (2016) Incidence, cost, complications and clinical outcomes of iatrogenic urethral catheterization injuries: a prospective multi-institutional study. J Urol 196:1473–1477. https://doi.org/10.1016/j.juro.2016.05.114

    CAS  Article  Google Scholar 

  4. Edwards JR, Peterson KD, Andrus ML, Tolson JS, Goulding JS, Dudeck MA, Mincey RB, Pollock DA, Horan TC (2007) National Healthcare Safety Network (NHSN) report, data summary for 2006, issued June 2007. Am J Infect Control 35:290–301. https://doi.org/10.1016/j.ajic.2007.04.001

    Article  PubMed  Google Scholar 

  5. Browne C, Norton S, Nolan JM, Whelan C, Sullivan JF, Quinlan M, Sheikh M, Mc Dermott TED, Lynch TH, Manecksha RP (2018) The impact of a structured clinical training course on interns’ self-reported confidence with core clinical urology skills. Ir J Med Sci 187:255–260. https://doi.org/10.1007/s11845-017-1616-x

    CAS  Article  PubMed  Google Scholar 

  6. Yang RL, Reinke CE, Mittal MK, Kean CR, Diaz E, Fishman NO, Morris JB, Kelz RR (2012) The surgery clerkship: an opportunity for preclinical credentialing in urinary catheterization. Am J Surg 204:535–539. https://doi.org/10.1016/j.amjsurg.2012.01.015

    Article  PubMed  Google Scholar 

  7. Thomas AZ, Giri SK, Meagher D, Creagh T (2009) Avoidable iatrogenic complications of urethral catheterization and inadequate intern training in a tertiary-care teaching hospital. BJU Int 104:1109–1112. https://doi.org/10.1111/j.1464-410X.2009.08494.x

    Article  PubMed  Google Scholar 

  8. General Medical Council (2018) Outcomes for graduates. GMC Publ

  9. General Medical Council (2019) Practical skills and procedures. GMC Publ

  10. Medical Council of Ireland (2012) National Intern Training Programme (NITP). Education and Training in the Intern Year. p 1–36

  11. Geeky Medics Male Catheterisation - OSCE Guide. https://geekymedics.com/penile-catheterisation-osce-guide/. Accessed 1 Jul 2019

  12. Hashim H, Jones P, Flynn KJO, et al (2012) An undergraduate syllabus for urology. Br Assoc Urol Surg

  13. American Urological Association Medical Students Curriculum - American Urological Association. https://www.auanet.org/education/auauniversity/education-and-career-resources/for-medical-students. Accessed 1 Jul 2019

  14. Obeso V, Brown D, Phillipi C, et al (2017) Core entrustable professional activities for entering residency Pilot Program. Toolkits for the 13 Core Entrustable Professional Activities for Entering Residency. 20. https://doi.org/aamc.org/initiatives/coreepas/publicationsandpresentations

  15. Bhatt NR, Davis NF, Quinlan MR, Flynn RJ, McDermott TED, Manecksha RP, Thornhill JA (2017) A prospective audit on the effect of training and educational workshops on the incidence of urethral catheterization injuries. Can Urol Assoc J 11:E302–E306. https://doi.org/10.5489/cuaj.4271

    Article  PubMed  PubMed Central  Google Scholar 

  16. Carter R, Aitchison M, Mufti GR, Scott R (1990) Catheterisation: your urethra in their hands. Br Med J 301:905. https://doi.org/10.1136/bmj.301.6757.905

    CAS  Article  Google Scholar 

  17. Gonzalez L, Sole M Lou (2014) Urinary catheterization skills: one simulated checkoff is not enough. Clin Simul Nurs 10:455–460. https://doi.org/10.1016/j.ecns.2014.07.002

  18. Lehmann R, Seitz A, Bosse HM, Lutz T, Huwendiek S (2016) Student perceptions of a video-based blended learning approach for improving pediatric physical examination skills. Ann Anat 208:179–182. https://doi.org/10.1016/j.aanat.2016.05.009

    Article  PubMed  Google Scholar 

  19. Öztürk D, Dinç L (2014) Effect of web-based education on nursing students’ urinary catheterization knowledge and skills. Nurse Educ Today 34:802–808. https://doi.org/10.1016/j.nedt.2013.08.007

    Article  PubMed  Google Scholar 

  20. Sullivan JF, Forde JC, Thomas AZ, Creagh TA (2015) Avoidable iatrogenic complications of male urethral catheterisation and inadequate intern training: a 4-year follow-up post implementation of an intern training programme. Surgeon 13:15–18. https://doi.org/10.1016/j.surge.2014.02.001

    CAS  Article  PubMed  Google Scholar 

Download references

Acknowledgments

I wish to thank Mr. Adam Roche, RCSI, who provided us with the catheterisation models and I am grateful for his assistance in this regard.

Author information

Affiliations

  1. Department of Urology, Beaumont Hospital, Dublin, Ireland

    Aisling U. Nic an Ríogh, Clare O’Connell, Peter E. Lonergan & Niall F. Davis

Authors
  1. Aisling U. Nic an Ríogh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Clare O’Connell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter E. Lonergan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Niall F. Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by A Nic an Ríogh. The first draft of the manuscript was written by A Nic an Ríogh and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Aisling U. Nic an Ríogh.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This research follows the principles of the Declaration of Helsinki.

Consent to participate

Verbal informed consent was obtained from all participants.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nic an Ríogh, A.U., O’Connell, C., Lonergan, P.E. et al. Designing and assessing a urethral catheter skills workshop for intern doctors in a university teaching hospital. Ir J Med Sci 189, 1501–1506 (2020). https://doi.org/10.1007/s11845-020-02240-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-020-02240-4

Keywords

  • Education
  • Patient safety
  • Urethral catheterisation
  • Urology