Nurses’ experiences of caring for non-catheterized older infirmed patients: A descriptive study of what nurses actually do?

Abstract

Aims This study aims to explore nurses’ experiences of caring for non-catheterised older infirmed patients who had suffered from recurrent urinary tract infection and strategies adopted to prevent and manage the problem.

Background Urinary tract infection is a complex and significant infection affecting frail older patients. Most literature focuses on prescribing treatment to treat the micro-organisms causing the infection, with less emphasis to understand nursing perspectives of caring for frail and highly dependent older patients suffering from this condition.

Design Qualitative

Methods A qualitative research methodology was conducted in a hospital-based infirmary unit (composing of four wards) in Hong Kong. Fourteen nurses were interviewed using a semi-structured interview guide.

Results When managing recurrent urinary tract infection of non-catheterised older patients, nurses described the need to promptly recognise the urinary tract infection symptoms and to know the causes of the symptoms before administering any care. These formed the basis for deciding whether the patient’s urinary condition should be managed by nurses themselves or be referred to the physician for medical treatment. Based on this initial judgement, subsequent non-invasive measures perceived by nurses to be effective were undertaken to manage the non-medically intervened problem. Ways to improve nurses’ existing roles and work practices to better manage recurrent urinary tract infection of non-catheterised older patients were also identified.

Conclusion Nurses working in infirmary wards refocused on the value of providing basic nursing care to manage this emergent and overlooked clinical problem.

Relevance to clinical practice Asymptomatic urinary tract infection cases should continue to receive ‘basic urinary tract infection care’ on a daily basis, as ignoring these symptoms could bring on adverse consequences. Prior knowledge and experiences acquired by nurses who cared for previously infected patients can assist in the development of interventions, so comparison of different nursing measures is possible to determine which one is the most effective in managing this clinical issue.