Manual bladder washouts for urinary clot retention: a survey of knowledge among healthcare workers

Abstract

INTRODUCTION: Manual bladder washouts (MBWs) are an integral skill for healthcare workers dealing with urological patients. Despite this they are often overlooked by educators and omitted from formal teaching curricula. We aimed to determine the level of competence and training among healthcare workers in performing a MBW. MATERIALS AND METHODS: Following a literature review for correct MBW technique, a 15-question survey was developed to assess knowledge and self-reported competency of doctors and nurses in performing a MBW. Two hundred paper and email-based surveys were distributed to doctors and nurses in the urology wards of Australian public and private hospitals. RESULTS: The survey response rate was 79% with the majority of responses received from senior nurses and surgical registrars, comprising a final study population of 133 respondents. Reported levels of education pertaining to MBW were poor, with only 5% of doctors and 35% of nurses claiming to have been taught the skill as a student. Opinions surrounding the technical aspects of MBW varied significantly across both clinician and nursing subgroups. Interpretation of completion of a MBW was inconsistent, with 72% of nurses stating this occurred when continuous irrigation ran freely compared to only 25.3% of registrars. Despite this, confidence in performance of a MBW in clinicians was high (> 95% agree or strongly agree). Confidence levels in knowledge and procedural skills were significantly lower in the nurse cohort than the registrar cohort (p < 0.01). CONCLUSIONS: The indications and technique for MBW are poorly described in the literature. Despite high self-reported competency, MBW appears poorly understood by both doctors and nurses. This valuable and common skill is rarely taught to healthcare students, suggesting better education may improve expertise and patient outcomes.