Developing a ‘no indwelling catheter’ intervention to reduce catheter-associated urinary tract infection in acute care (HS3)

Project Summary:

Approximately 80% of urinary tract infection (UTI), a leading cause of healthcare-associated infection, is related to indwelling urinary catheterisation (IUC) (King et al, 2012). 1 in 4 hospitalised patients undergoes IUC and overuse is common (Saint et al, 2000).

In patients undergoing surgery, IUC is often used routinely to empty the bladder or to manage postoperative urinary retention. Whereas for some kinds of surgery IUC is essential, for other kinds (e.g. lower limb joint replacement surgery) the use of alternative strategies is both possible and desirable as a means to minimise the risk of UTI and other complications. Intermittent (in-out) catheterisation (IC) in combination with bladder ultrasound scanning is an underexploited intervention in acute care. There is much potential to test it more comprehensively in combination with other strategies to replace IUC, including nursing interventions to promote spontaneous voiding and detect and manage post-operative urinary retention.

Replacing IUC with IC is a complex intervention, which requires development and piloting before it can be evaluated on a large scale and replicated. It involves the use of additional strategies in conjunction with IC in order to minimise the risk of urinary retention and prevent bladder over-distension. These include fluid management, choice of anaesthetic, early bladder ultrasound scanning and early voiding techniques, which have themselves received limited attention. In ‘enhanced recovery’ pathways for patients undergoing elective lower limb joint replacement surgery, where IC is specifically recommended in place of IUC, its adoption has failed to become embedded in practice, partly as a result of the above-mentioned complexities.

This research project will form part of an established programme of research and quality improvement to reduce catheter-associated UTI in acute care. It aims to identify the essential components of an intermittent catheterisation ‘package’ required to bring about successful implementation of a ‘no indwelling catheter’ strategy in patients undergoing elective lower limb joint surgery and will provide the basis of a future large-scale randomised controlled trial.

Project Details:

The Faculty of Health Sciences, University of Southampton working in partnership with University Hospital Southampton NHS Foundation Trust, is offering a Clinical Academic Doctoral Fellowship for a qualified nurse.

The successful candidate will spend two days per week as a Band 5 Registered Nurse in University Hospital Southampton NHS Foundation Trust and 3 days per week working on the PhD research study. You will join a thriving and expanding group of Clinical Academic Doctoral Fellows based at the Clinical Academic Facility, Southampton General Hospital for the academic component of the Fellowship.

The Fellowship is for 4 years will begin in September 2013. You will be supported by an annual £14,000 stipend and an additional sum of £800 to support additional training and development costs during the Fellowship.

This is an exciting opportunity and will enable aspiring individuals to combine clinical practice with a research role, working across the University and University Hospital Southampton NHS Foundation Trust. The successful candidate will work with their nominated clinical mentor and a Faculty of Health Sciences academic mentor in a tri-partite arrangement to develop their clinical academic role in both practice and University settings.

It is essential that you have successfully achieved a 2:1 or a Postgraduate Diploma distinction in nursing. It would be desirable if you have achieved a 1st class honours degree.

Further information can be found in our FAQ document by clicking "Apply Online" below.

Interviews will be held in Southampton on 21st June 2013.