One product we are delighted to have added to our portfolio here at Pennine Healthcare, is the NICE-approved Urethral Catheterisation Device (UCD®) – the world’s first Foley catheter with integrated guidewire.
A safe second-line catheterisation solution, when standard Foley-catheterisation has failed, we were keen to speak to people who have been using the UCD® to get their take on what makes the product such a useful device. We have spoken to three separate individuals, each with a slightly different take on how the UCD has benefited their working life and will be releasing the blog in three separate instalments.
First in the Urethrotech UCD® Case Study is Gemma Berry, Modern Matron at Thundersley & Canvey Clinic, who has been using the UCD within her community, for a number of months now. We caught up with Gemma to see how she has been getting on, and you can read the interview below:
Pennine Healthcare, working alongside Consultant Urologist Dr Daniela Andrich in the design and production of an innovative instrument called a Urethral Catheterisation Device (Urethrotech UCD) which will join our existing medical device range, approached Essex Partnership University Trust (EPUT) District Nursing Service with a view to trialling the product in the Community setting. The Hospital trial at University College London Hospital had been successful and now well established throughout the Trust.
The UCD is the first urinary catheter on the market to incorporate a hydrophilic nitinol guidewire into its design to manage difficult or failed urethral catheterisation.
The National Institute for Clinical Excellence (NICE) acknowledges that the UCD could be used in any healthcare setting by appropriately trained health care professionals who would otherwise perform urethral catheterisation.
The UCD appears very much like a standard urethral catheter and the technique approach to inserting is very much in line with using a standard catheter.
There are clear tangible benefits to patients, healthcare practitioners and the healthcare system as a whole:
As part of the District Nursing Transformation Project (2019) within EPUT, new initiatives for best practice and interventions were sourced. This was also to look at strengthening admission avoidance for non-urgent care and treatment.
It was identified that a cohort number of male catheter patients were admitted to the A&E department via the community due to re-catheterisation issues, i.e. the nurse could not insert a new urethral catheter due to a blockage or an enlarged prostate.
Patients cared for by the community District Nursing team can have extremely complex needs. We identified that out of our cohort of patients; approx. 30% have urinary catheter care needs. The UCD had the potential for community nurses to treat male patients with a non-complex urology history within their own homes and in doing so, upskilling staff in this treatment, prevent unnecessary hospital admission and provide high quality of care to our patients. The device had previously only been used in hospital settings and we wanted to see if was suitable for use in the community – this would be the first trial nationally.
We identified Canvey Island as the test site and the patient cohort and involved the local Canvey Island District Nursing team to carry out the trial over a 12-month period. Due to this being a small cohort of patients who may require the use of the UCD, and the first of its kind, it was set up to trial over a year with regular meetings with Dr Daniella Andrich for support and guidance on any issues we may come across.
The UCD is easily ordered via NHS supply with plans for it to be put onto FP10 in the future. This would allow Team Leaders to prescribe the device as a rescue back-up plan and could be held in the patient’s home for when necessary to use. Training staff with the UCD and completing competencies has been successful and staff feel they able to give their patients more choice with their treatment.
Patients have been very pleased with the device and feel less anxious. This in turn makes their experience much more positive. The District Nursing service at Canvey has managed to keep at least 10 patients at home and treat successfully in a 12 month period. This being just one small area of Essex.
The device is cost effective, saves unnecessary hospital admission, and has time saving benefits for staff.
By identifying patients who would benefit from the use of the UCD when a standard catheter is not successful, the nurse has a treatment plan to prevent transferring their patient to A&E for insertion of a catheter under anaesthetic. By using the UCD the nurse can reassure the patient by instantly relieving physical pressure and discomfort as well as reducing their anxieties about visiting hospitals during a pandemic.
Patients have found the device a comfort, to know it is there for their back-up plan and prevention of hospital admission, especially in our current pandemic climate.
Here is some patient feedback:
With the successful pilot at Canvey Island District Nursing, the UCD training and roll out was extended to Southend District Nursing for a larger cohort of patients. This commenced in September 2021 and has been largely successful. Data will be collected and collated to evidence the use of a UCD is successful within the community to prove its use in unnecessary hospital admissions.
Furthermore, as part of the Mid & South Essex (MSE) transformation programme between 3 local hospitals and community services, a catheter pathway is being established alongside a monthly MDT to discuss ongoing patient care and issues. The MDT includes Urology Consultants, GP’s, Specialist Nurses, Community Matrons and CCG. Here the UCD good practice has been shared with colleagues and a presentation held with Dr Daniela Andrich to the increased interest in the device. There is an opportunity for learning from these pilots can benefit more patients at scale across parts of the Essex County.
For community nurses an alternative preventative way to reduce unnecessary re-catheterisation hospital admissions, the UCD should be considered. With training it is easy to use and delivers an effective intervention in the comfort of the patient’s home. The device is cost effective compared with ambulance transfers and A&E admission costs. Training staff in the correct use of the UCD and identifying patients appropriately, enables community nurses to continue to deliver high quality care in a community setting.
