Australian College of Nursing
Recommendations from the Australian College of Nursing on peripheral IV catheters, blood glucose self-monitoring, antipyretics, urinary catheters & x-rays for ankle trauma. The Australian College of Nursing (ACN) is the national professional organisation for nurses in health and aged care settings. ACN provides nursing expertise to government and key stakeholders, and seeks to enhance the expertise of nurses when providing leadership and contribution to policy, practice and delivery of health care.
Don’t use urinary catheters to manage urinary incontinence unless all other appropriate options have proved to be ineffective or to prevent wound infection or skin breakdown.
Urinary tract infections (UTIs) are the most common healthcare associated infection, the majority of which can be associated with the use of indwelling urinary catheters (IDC). Urinary tract infections in hospitalised patients increase morbidity and mortality, antibiotic exposure and often prolong length of hospital stay.
The use of indwelling urinary catheters to manage incontinence is not recommended unless as a last resort or to prevent wound infection or skin breakdown and should be removed as soon as possible.
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- Meddings J, Rogers M AM, Krein SL, Fakih MG, Olmsted RN & Saint S. Reducing unnecessary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Quality and Safety. 2013; 0; 1-3.
- Saint, S, Greene TM, Kowalski CP, Watson SR, Hofer TP, Krein SL. Preventing catheter-associated urinary tract infection in the United States: A comparative study. JAMA Intern Med 2013;173 (10):874-879.
- Tominaga GT, Dhupa A, McAllister SM, Calara R, Peters SA, Stuck A. Eliminating catheter-associated urinary tract infections in the intensive care unit: is it an attainable goal? The American Journal of Surgery 2014 208:1065-1070.
The Australian College of Nursing (ACN) as nursing lead, established a collaborative working party incorporating a diverse range of nursing expertise. Professional nursing bodies involved in initial collaboration included: Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM); CRANAplus; Australian Primary Health Care Nurses Association (APNA); Australian College of Mental Health Nurses (ACMHN).
ACN’s membership was consulted via publications, web site and ACN’s National Nursing Forum. This consultation provided a broad view from our members regarding planning and delivery of nursing care across Australia. An interactive session invited delegates to actively participate in identifying those nursing practices, interventions, or tests that evidence shows provide no benefit or may even lead to harm. This informative stimulating session examined a range of nursing practices and their effects on healthcare consumers.
At this point specialist nursing groups were approached for comment on our recommendations. This group included: Australasian College for Infection Prevention and Control (ACIPC); Australian Diabetes Educators Association (ADEA); Continence Nurses Society Australia (CNSA); Australian and New Zealand Urological Nurses Society (ANZUNS); Medical Imaging Nurses Association (MINA); and the Australian and New Zealand Orthopaedic Nurses Association (ANZONA). Final consultation with ACN Members and Fellows prior to submission ensured a collaborative result.
- 1 Don’t replace peripheral intravenous catheter unless clinically indicated.
- 2 Don’t restrict the ability of people with diabetes to self-manage blood glucose monitoring unless there is a clinical indication to do so.
- 3 Don’t routinely administer antipyretics with the sole aim of reducing body temperature in un-distressed children.
- 4 Don’t use urinary catheters to manage urinary incontinence unless all other appropriate options have proved to be ineffective or to prevent wound infection or skin breakdown.
- 5 Don’t initiate plain X-ray for foot and ankle trauma unless criteria of the Ottawa Ankle Rules are met.