Abstract
We examined spinal cord injury (SCI) catheterization practices in Australia to understand
practice patterns and consistency with research evidence. A national facilitated discussion
forum was held during the annual Australian and New Zealand Spinal Cord Society conference
attended by 66 conference delegates. Initially, presentations were given on the latest
laboratory research examining bladder changes following SCI; an overview of evidence-based
recommendations indicating that intermittent catheterization is best practice; and
results of a single-center practice audit that demonstrated substantial delay in transition
between acute SCI and intermittent catheterization. The ensuing discussion covered
current catheterization practices in both inpatient SCI units and the community and
highlighted gaps between evidence and practice, with considerable variation in practice
between centers and settings. Reported challenges to implementing best practice included
social, economic, and resource factors. A disconnect between hospital and community
practice was also identified as an important barrier to long-term uptake of intermittent
catheterization following acute SCI. The discussion identified 3 proposed activities:
(1) explore current practice and bladder health following SCI in greater depth across
SCI units and in local communities through audits and standardized biochemical analysis;
(2) determine the behavioral drivers of current practice; and (3) develop a knowledge
translation strategy to better align practice with current clinical practice guidelines.
Keywords
List of abbreviations:
ANZSCoS (Australian and New Zealand Spinal Cord Society), CPG (clinical practice guideline), IC (intermittent catheterization), IDC (indwelling catheter), SCI (spinal cord injury), UTI (urinary tract infection)To read this article in full you will need to make a payment
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References
- Targeting recovery: priorities of the spinal cord-injured population.J Neurotrauma. 2004; 21: 1371-1383
- Incidence of acute care adverse events and long-term health-related quality of life in patients with TSCI.Spine J. 2015; 15: 923-932
- Complications Audit of Urological Issues in Spinal Cord Injury Evaluation Study (CAUSES). Institute for Safety CaRR ed..Institute for Safety, Compensation and Recovery Research, Melbourne, Australia2015
- Urinary tract infections in spinal cord injury: prevention and treatment guidelines.Acta Clin Belg. 2009; 64: 335-340
- Management of the neurogenic bladder for adults with spinal cord injuries.NSW Agency for Clinical Innovation, Chatswood, Australia2014
- The encrustation and blockage of long-term indwelling bladder catheters: a way forward in prevention and control.Spinal Cord. 2010; 48: 784-790
- Urinary catheter-associated infections.Infect Dis Clin North Am. 2012; 26: 13-27
- Strategies to promote intermittent self-catheterisation in adults with neurogenic bladders: a comprehensive systematic review.JBI Libr Syst Rev. 2011; 9: 1392-1446
- Bladder management for adults with spinal cord injury: a clinical practice guideline for health-care providers.J Spinal Cord Med. 2006; 29: 527-573
- Summary of European Association of Urology (EAU) guidelines on neuro-urology.Eur Urol. 2016; 69: 324-333
- Audit of early bladder management complications after spinal cord injury in first-treating hospitals.Eur Urol. 2000; 37: 156-160
- Profile and costs of secondary conditions resulting in emergency department presentations and readmission to hospital following traumatic spinal cord injury.Injury. 2016; 47: 1847-1855
- Social activity and relationship changes experienced by people with bowel and bladder dysfunction following spinal cord injury.Spinal Cord. 2017; 55: 679-686
- Knowledge translation of research findings.Implement Sci. 2012; 7: 50
- Knowledge Translation Platform Evaluation Study Team. Evidence briefs and deliberative dialogues: perceptions and intentions to act on what was learnt.Bull World Health Organ. 2014; 92: 20-28
- Making evidence based medicine work for individual patients.BMJ. 2016; 353: i2452
Article info
Publication history
Published online: May 30, 2018
Footnotes
Supported by the Transport Accident Commission, through the Institute for Safety, Compensation and Recovery Research.
Disclosures: P.B. is a member of the Spinal Cord Injury Network board, a not-for-profit organization with a mission to improve spinal cord injury research and care. P.B. receives reimbursement for costs associated with attending board meetings. The other authors have nothing to disclose.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
