Authors (including presenting author) :
Yeung WS (1), Wong SY (1), Yim TY (1), Wong SF (1), Hung YW (1), Leung MK (1), Chan PY (1), Lam PL (1)
Affiliation :
(1) Community Nursing Service, Our Lady of Maryknoll Hospital
Keyword 2: :
Trial Without Catheter
Keyword 4: :
Urinary Catheter Care
Keyword 5: :
Nurse-Led Training
Keyword 6: :
Community nursing service
Introduction :
For elderly patients, prolonged use of urinary catheters increases the risk of complications, most notably catheter-associated urinary tract infections (CAUTIs), which harm their health and quality of life, and burden to the healthcare system. As this risk increases with duration, timely assessment, patient education and a successful Trial Without Catheter (TWOC) are critical. Currently, however, many TWOC referrals to Community Nursing Services (CNS) are made without standardized protocols, resulting in inconsistent staff practices and education. Furthermore, patients often receive no formal educational materials about the process. Research indicates that implementing a structured, community-based and nurse-led TWOC service offers a safe and effective approach to urinary catheter removal. Moreover, supplementing this model with digital educational tools has proven beneficial for improving a better understanding and outcomes.
Objectives :
1.Develop a holistic TWOC empowerment program via multi-media learning materials in CNS 2.Standardize and align procedure of TWOC with evidence-based practice and established guidelines in CNS 3.Enhance knowledge and skills of staffs and patients/caregivers in urinary catheter and TWOC care in CNS
Methodology :
The project was divided into 3 phases: development, delivery and outcome measurement. In Phase 1, after literature review, a colorful A4 poster, an 8-minute video and a satisfaction survey were developed. 2 sets of pre & post knowledge test were created for evaluating both patients and nursing staff. Prior to roll-out, a 20-minute sharing session was held for nursing staff. In Phase 2, the program was offered to new TWOC referrals that lacked of designated protocol. We engaged patients and caregivers during first home visit, delivery of video was illustrated by a QR code on the poster which provided immediate, flexible access and no geographical barriers to receiving key information. In Phase 3, we compared pre- & post-test scores from patients and staff for evaluating improvement. Staff completed the test before and after training session. Patients took the pre-test during initial home visit and the post-test, along with a satisfaction survey, on the day of TWOC after its completion.
Result & Outcome :
This project was conducted from April to November 2025. 31 patients were recruited, 75% of patients were over 65 years old, and approximately 60% had less than a primary education. Among caregivers, nearly half were over 51 years old, with 60% having less than a secondary education. The pre-test mean score for patients was 7.35 (out of 10), which improved to 9.84 in the post-test, resulting in a program success rate of 71% in TWOC. Over 94% of patients agreed that the educational poster and video were useful for enhancing their understanding towards TWOC procedure, reducing anxiety, and expressed overall satisfaction with the program. No CAUTIs occurred in the cohort of 31 patients. For nursing staffs, the sharing session significantly improved knowledge. The mean pre-test score was 7.68 (out of 12), which increased to 11.28 in the post-test, confirming the session's effectiveness in enhancing staff competency in catheter care and TWOC procedures in community care.
