{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:24:42Z","timestamp":1793845482102,"version":"4.6.1"},"reference-count":30,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Qual Saf"],"accepted":{"date-parts":[[2015,4,30]]},"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Indwelling urinary catheters (IUCs) placed in acute care are a leading cause of healthcare-associated urinary tract infection. Despite initiatives to minimise the placement of IUCs, levels of inappropriate use are still considered unacceptable. IUC practice is difficult to change, and factors influencing clinicians\u2019 decisions need to be better understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To explore why clinicians decide to place IUCs in acute medical care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a qualitative study in the emergency department and acute medical wards of a 1200+ bed hospital, undertaking 30 retrospective think aloud and 20 semistructured interviews with nurses and physicians who made the decision to place an IUC. A purposive sample and thematic analysis were used.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Opinions on when an IUC was warranted varied considerably. Inconsistency in decision-making was caused by differing beliefs on when an IUC was appropriate for each clinical indication. Numerous patient and non-patient factors, including clinical setting, resources, patient age and gender and staff workload, also impacted on each decision. Assessing when the benefit of an IUC outweighed the risk could be problematic due to conflicting goals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings help to explain why clinicians sometimes deviate from IUC best practice guidance and resist interventions to modify practice. In order to engage nurses and physicians in change, interventions to reduce IUC use should acknowledge and respond to the complexity and lack of clarity often faced by clinicians making the decision to place an IUC. However, it is equally important that inconsistencies in IUC-related beliefs are recognised, investigated and, where appropriate, challenged.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjqs-2015-004114","type":"journal-article","created":{"date-parts":[[2015,6,11]],"date-time":"2015-06-11T20:15:15Z","timestamp":1434053715000},"page":"444-450","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["\u201cIt's easier to stick a tube in\u201d: a qualitative study to understand clinicians\u2019 individual decisions to place urinary catheters in acute medical care"],"prefix":"10.1136","volume":"24","author":[{"given":"Catherine","family":"Murphy","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqui","family":"Prieto","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Fader","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,6,11]]},"reference":[{"key":"2025090409170834000_24.7.444.1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.2807\/ese.17.46.20316-en","article-title":"The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use","volume":"17","author":"Zarb","year":"2012","journal-title":"Euro Surveill"},{"key":"2025090409170834000_24.7.444.2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.627"},{"key":"2025090409170834000_24.7.444.3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ajic.2011.03.032","article-title":"Inappropriate use of urinary catheters: A prospective observational study","volume":"40","author":"Tiwari","year":"2011","journal-title":"Am J Infect Control"},{"key":"2025090409170834000_24.7.444.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306801"},{"key":"2025090409170834000_24.7.444.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005099"},{"key":"2025090409170834000_24.7.444.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2012.07.022"},{"key":"2025090409170834000_24.7.444.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2011-000473"},{"key":"2025090409170834000_24.7.444.8","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1136\/bmjqs-2012-001774","article-title":"Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review","volume":"23","author":"Meddings","year":"2013","journal-title":"BMJ Qual Saf"},{"key":"2025090409170834000_24.7.444.9","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.hrtlng.2011.08.001","article-title":"Guidelines to prevent catheter-associated urinary tract infection: 1980\u20132010","volume":"41","author":"Conway","year":"2011","journal-title":"Heart Lung"},{"key":"2025090409170834000_24.7.444.10","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ijnurstu.2012.12.007","article-title":"Interventions to minimise the initial use of indwelling urinary catheters in acute care: a systematic review","volume":"1","author":"Murphy","year":"2014","journal-title":"Int J Nurs Stud"},{"key":"2025090409170834000_24.7.444.11","doi-asserted-by":"publisher","DOI":"10.1086\/651091"},{"key":"2025090409170834000_24.7.444.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2009.04.017"},{"key":"2025090409170834000_24.7.444.13","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2346.1999.00522.x"},{"key":"2025090409170834000_24.7.444.14","doi-asserted-by":"publisher","DOI":"10.1177\/1062860605276074"},{"key":"2025090409170834000_24.7.444.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2009.00677.x"},{"key":"2025090409170834000_24.7.444.16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a963"},{"key":"2025090409170834000_24.7.444.17","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.105"},{"key":"2025090409170834000_24.7.444.18","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-13-151"},{"key":"2025090409170834000_24.7.444.19","doi-asserted-by":"crossref","unstructured":"Mizerek E , Wolf L . To foley or not to foley: emergency nurses\u2019 perceptions of clinical decision making in the use of urinary catheters in the emergency department. J Emerg Nurs. In Press. http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0099176714004243 (accessed Feb 2015).","DOI":"10.1016\/j.jen.2014.09.009"},{"key":"2025090409170834000_24.7.444.20","unstructured":"Mulcare M , Rosen T , Slark S , et al . Provider perspectives on the use of indwelling urinary catheters in older adults in emergency department settings: Developing a novel clinical protocol. Am J Infect Control. In Press. http:\/\/www.ajicjournal.org\/article\/S0196-6553(14)01378-9\/abstract (accessed Feb 2015)."},{"key":"2025090409170834000_24.7.444.21","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1177\/0269215511426160","article-title":"Urinary catheterisation in acute stroke: clinical realities. 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