Introduction: Placement of coudé catheters, manual irrigation of catheters, and management of continuous bladder irrigation (CBI) are routine interventions for which nurses often receive little or no formal education. In this study, our aim was to determine factors associated with higher comfort levels for these catheter-care techniques and to assess whether online instructional videos could be used to improve nursing comfort.
Methods: Three five-minute videos were created to demonstrate proper technique for coudé catheter placement, manual irrigation of a catheter, and management of CBI. An online module with pre- and post-video surveys was created and administered to all nursing staff at MedStar Georgetown University Hospital from February to March 2020. Surveys assessed demographics, prior formal catheter training, prior experience, and associated subjective comfort levels on a Likert scale from 1-10. All data were collected in an anonymous fashion and statistical analysis was performed using STATA. Wilcoxon signed-rank test was utilized to compare pre- and post-video comfort levels. Linear regression models were created to determine factors associated with higher comfort levels on the pre-video survey. Statistical significance was defined as p < 0.05.
Results: A total of 821 nurses participated in this study. Mean age for nursing staff was 33.5 years ± 11.7, and mean years of nursing experience was 8.8 years ± 10.4. Only 20.2 % (n = 166), 42.8% (n = 351), and 39.5% (n = 324) reported prior formal training for placement of a coudé catheter, manual irrigation of a catheter, or management of CBI, respectively. Using a 10-point Likert scale, pre-video median comfort levels for coudé catheter placement, manual irrigation of a catheter, and management of CBI were 5, 6, and 5, respectively. Post-video median comfort levels increased significantly to 9, 8, and 8, respectively (p < 0.001). In the linear regression models, prior formal training was significantly associated with higher baseline comfort levels for all three techniques (p < 0.001).
Conclusions: Prior formal training as well as baseline nursing comfort levels for common catheter related techniques tend to be low and the implementation of simple instructional videos via an online platform may be a useful strategy for improving nursing comfort. This study highlights the importance of establishing standardized catheter education protocols and demonstrates a feasible and reproducible strategy for disseminating education for nurses on a larger scale.
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