Urinary retention in older patients in connection with hip fracture surgery

AIM AND OBJECTIVE: The aim of this study was to examine the presence of urinary retention in older patients with hip fracture and to describe what actions nurses performed to detect, prevent and treat urinary retention. BACKGROUND: The incidence of urinary retention in patients with hip fracture is described as being as high as 82% before surgery and 56% after. Urinary retention is traditionally treated with an indwelling urethral catheter or intermittent catheterisation. Urinary retention and treatment with an indwelling urethral catheter are associated with high risks. DESIGN: A prospective, descriptive study. METHODS: The study included 48 patients, 65 years or older who were recovering from hip fracture and receiving hospital care at a geriatric rehabilitation clinic. Six months before the study, a programme for the early detection, prevention and treatment of urinary retention was implemented. The presence of urinary retention, bacteriuria, the patient's cognitive function, use of ultra-sound bladder scan and type of treatment whether the patient suffered from urinary retention were examined during the study period. RESULTS: Urinary retention was found in 18 (38%) of the patients. No patients were examined using ultrasound bladder scan according to the programme, and the mean time of indwelling urethral catheter was three times longer than the programme suggested. The patients who were treated with intermittent catheterisation had had voiding satisfaction earlier and had not had repeated urinary retention compared to patients with indwelling urethral catheter. CONCLUSION: In most patients, the programme was not followed and urinary retention was commonly present. RELEVANCE TO CLINICAL PRACTICE: There is knowledge on how to reduce the presence of urinary retention, but the great challenge is how to implement this knowledge.