Introduction: Insertion of a urinary catheter in the acute hospital ward is a commonly seen for a variety of indications. In these cases, where a patient is well enough for discharge from acute services yet may not be able to void without a catheter, a trial without catheter after a period of recuperation is warranted. In aged care facilities, where patients often have poor functional status, transfer to a hospital clinic may prove burdensome. We assess the feasibility of performing trials without catheters within the aged care home using a mobile geriatric service that can review patients within their residence.
Methods: We retrospectively analyse the electronic medical records of a tertiary teaching hospital for patients referred for a trial without catheter after an acute hospital admission. Patients who reside in aged care facilities where a trial without catheter performed within their home were identified. Data collection period was from 1st January 2018 to 30th April 2021. For patients who had voided successfully, follow up telephone reviews were performed for all patients the next day to identify any issues prior to formal discharge from the service.
Results: A total of 65 cases were identified. Mean age of the cases was 85.6 years. 44 referrals were for male patients and 21 were for female patients with 40 (61.5%) of all cases also having delirium or dementia, and 35 (53.8%) requiring assistance or hoist for transfers.
Trial without catheter were performed successfully in 45 (69.2%) of cases. Of the remainder, 14 (21.5%) cases failed a trial without catheter and 6 cases were referred for acute admission for reasons unrelated to the urinary catheter. Of those that failed, 3 were planned for another trial without catheter and the remainder 11 (16.9%) were referred to outpatient urology review.
On follow up telephone reviews for the 45 cases were trial without catheter were successful, no further voiding issues were identified. No new issues pertaining to patient’s cognitive and mobility status were identified.
Conclusions: Trial without catheter within the aged care facility is safe and feasible. Visiting clinicians were able to effectively manage trials without catheters, including patients who failed to void. All of these cases would otherwise require attendance to the trial without catheter clinic. In the current pandemic climate where services are limited to accommodate for COVID-19 patients, minimising transfer of frail, aged care residents to the hospital reduces urology clinic workload and keeps this vulnerable cohort away from potential COVID-19 exposure.
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