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Management of elderly woman’s recurrent UTIs and catheter care in rest home
Management of elderly woman’s recurrent UTIs and catheter care in rest home
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Deputy Health and Disability Commissioner Rose Wall today released a report finding a rest home owned and operated by Residential Management Limited (RML) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for its management and treatment of a woman’s recurrent urinary tract infections (UTIs) and poor catheter care.
The woman, aged in her nineties, had multiple complex health issues and needed hospital-level care. Two months after moving to the rest home, she was hospitalised for a UTI. When she returned to the rest home, she had a permanent indwelling catheter and frequent bowel incontinence. In the subsequent months, the woman developed further UTIs on several occasions. Sadly, the woman died after being hospitalised for another UTI.
Rose Wall highlighted the importance of detailed catheter care planning and the management of recurrent UTIs in consumers with continence issues.
Ms Wall considered that management of the woman’s health was complex, and staff put considerable effort in providing care to the woman in some areas. However, Ms Wall criticised the rest home’s poor management and treatment of the woman’s UTIs, including a lack of short term care plans, and no consideration of different interventions. Ms Wall considered the woman’s catheter care was also poorly managed, with staff failing at times to empty the catheter bag or change it.
"[I]naction and failure by multiple staff to adhere to policies and procedures points towards an environment that does not support and assist staff sufficiently to do what is required of them and ensure that its residents receive optimal support, and RML must bear overall responsibility for this," Ms Wall said.
Ms Wall recommended that RML provide a written apology to the family, develop and present training to its staff on management of UTIs and catheter care, update its UTI and catheter care policies, and consider developing a form for recording discussions with families and the resulting decisions about a resident’s care.
The full report for case 18HDC01468 is available on the HDC website.
https://www.hdc.org.nz/decisions/search-decisions/2020/18hdc01468/