Authors (including presenting author) :
Yeung SY(1), Sham CL(1), Chan PY(1), Choi WM(1), Li HK(1), Chan KK(1), Wong MK(1), Wong CW(1), Tsoi YK(1), Chung YY(2), Chan HL(3) (1) Department of Medicine, Haven of Hope Hospital) (2) Kowloon East Cluster Continence Nurse Consultant (3) Nursing Services Division, Haven of Hope Hospital
Affiliation :
Yeung SY(1), Sham CL(1), Chan PY(1), Choi WM(1), Li HK(1), Chan KK(1), Wong MK(1), Wong CW(1), Tsoi YK(1), Chung YY(2), Chan HL(3) (1) Department of Medicine, Haven of Hope Hospital) (2) Kowloon East Cluster Continence Nurse Consultant (3) Nursing Services Division, Haven of Hope Hospital
Keyword 1: :
Urinary Catheter Fixation
Keyword 4: :
Urinary Catheter
Keyword 5: :
Catheter Fixation
Introduction :
Indwelling urinary catheters are commonly used in acute and long-term care settings. However, inconsistent fixation practices contribute to serious complications, including urethral trauma, catheter dislodgement, leakage, and catheter-associated urinary tract infections (CAUTIs). Despite explicit recommendations in the Hospital Authority Head Office Basic Nursing Standards for Patient Care – Urethral Catheter Care, baseline compliance check across all 17 wards at Haven of Hope Hospital revealed significant variations in fixation techniques and documentation. These findings necessitated a continuous quality improvement (CQI) programme to address gaps and promote standardized and strengthen the delivery of evidence-based catheter care.
Objectives :
The primary objective was to standardize indwelling urinary catheter fixation based on four core “right” principles: right position, right product, right method, and right technique. Secondary objectives included enhancing documentation completeness and accuracy, improving patient safety outcomes, reducing catheter-related complications, and fostering staff knowledge, confidence, and a safety culture through targeted education and reinforcement with compliance check for outcome evaluations.
Methodology :
A baseline compliance check was conducted across all 17 wards at Haven of Hope Hospital prior to intervention, followed by three compliance cycles in June, August, and October 2025 using checklists to assess fixation and documentation adherence. In April 2025, four interactive workshops trained 76 PCAs through lectures on best practices, live demonstrations, hands-on return demonstrations, pre- and post-training knowledge assessments, and staff satisfaction surveys. Sustainability measures included hospital-wide educational posters distributed to wards for display and plus ward-level visual aids on tape types and methods.
Result & Outcome :
Knowledge assessments showed substantial gains: pre-test scores averaged 83–85% correct, rising to over 97% post-test, representing a mean improvement of 14.2%. Fixation compliance advanced from approximately 59% at baseline to 93–95% in the second cycle, stabilizing at 84–85% by the third. Documentation compliance dramatically increased from 32.1% to 96.1%. Staff feedback was overwhelmingly positive, with confidence and safety awareness rated 5.6–5.8 out of 6, and overall satisfaction averaging 5.7/6. Qualitative comments praised the Omega fixation method as most practical and called for extended hands-on sessions.
