Urinary catheter management in connection with hip surgery

Patients undergoing hip surgery, either due to osteoarthritis or following a hip fracture, are usually treated with a urinary catheter during surgery. Postoperative urinary problems, such as urinary retention and urinary tract infections, are common among these patients. According to the results of systematic reviews, there is a lack of knowledge about how the urinary catheter should be handled in a safe manner to avoid these problems. It is therefore of great importance for patient safety to explore methods for urinary catheter management. Above all, there is a need of health economic studies that examine costs and health outcomes for patients and for health care, but there is also a need for studies that describe the patients' perspective on urinary catheterization.
The aim of the project is to compare and evaluate methods for urinary catheter management in patients undergoing hip surgery. The project comprises four studies: study I have a comparative design and examines risk factors and consequences of nosocomial urinary tract infections; study II is a randomized controlled trial (RCT) and examines methods for removal of the urinary catheter; study III is an RCT evaluating the effects of intermittent and indwelling urinary catheter treatment including a health economic evaluation; study IV is a qualitative study that describes patients' experiences of urinary catheterization in connection with hip surgery.
The project has clinical relevance, as the results of the studies can be used as basis for nurses’ decisions about urinary catheter management after hip surgery. The project is carried out in cooperation between the Department of Orthopaedics, Örebro University Hospital, and the School of Health and Medical Sciences, Örebro University, Sweden.

Publications and conference papers in the project

Hälleberg Nyman, M., Gustafsson M., Langius-Eklöf A. & Isaksson A.K. (2013). Patients’ experiences of bladder emptying in connection with hip surgery: an issue but of varying impact. Journal of Advanced Nursing, Epub ahead of print. doi:10.1111/jan.12156

Hälleberg Nyman, M., Gustafsson M., Langius-Eklöf, A., Johansson, J.E., Norlin, R. & Hagberg, L. (2013). Intermittent versus indwelling urinary catheterisation in hip surgery patients: A randomised controlled trial with cost-effectiveness analysis. International Journal of Nursing Studies, Epub ahead of print. doi.org/10.1016/j.ijnurstu.2013.05.007

Hälleberg Nyman, M. (2012). Urinary catheter policies for short-term bladder drainage in hip     surgery patients.  (Doctoral dissertation). Örebro: Örebro universitet.

Hälleberg Nyman, M., Johansson, J.E., Persson, K. & Gustafsson, M. (2011). A prospective study of nosocomial urinary tract infection in hip fracture patients. Journal of Clinical Nursing, 20, 2531–2539.

Hälleberg Nyman M, Langius-Eklöf M, Gustafsson M, Isaksson A-K. Experiences of urinary catheterization in patients operated with hip surgery. Föredrag vid ICN Conference 2011, “Nurses driving access, quality and health”, 2nd of May - 8th of May 2011, Valletta, Malta.

Hälleberg Nyman, M., Johansson, J.E. & Gustafsson, M. (2010).  A randomised controlled trial on the effect of clamping the indwelling urinary catheter in patients with hip fracture. Journal of Clinical Nursing, 19, 405–413.

Hälleberg Nyman M, Gustafsson M. Removal of the short-time indwelling urinary catheter in hip fracture patients. Föredrag vid 9th European Doctoral Conference in Nursing Science, Maastricht, Netherlands sept 2008