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Small changes, big differences

Infection prevention and catheter control

Rotherham NHS Foundation Trust

“Any measures which can be taken to potentially reduce the rates of infection should be given serious consideration,” says Helen Levers, a senior nurse in infection prevention and control at Rotherham NHS Foundation Trust.

In 2012, Helen’s service was invited to pioneer a potential answer to the problem of infection control in catheterisation. This involved switching from a saline solution to an antimicrobial cleaning solution developed by infection prevention specialist company, Schulke.

The product is used to clean the patient before catheterisation takes place or when a catheter is being changed.


Feedback on the new product from both patients and nursing staff has been overwhelmingly positive.

During the evaluation, trauma associated with the process of catheterisation reduced significantly and there were no reports of associated urinary tract infections.

For the company which developed the product, the ability to trial a product on the ground is essential. While researchers can come up with something that performs well in a laboratory, they need to know how well it works in practice, with both nurses and patients.


Among the patients who have benefited from the new approach is Jason, who was involved in a serious road traffic accident when he was 18.

The accident left Jason with a severe traumatic brain injury and very little sensation from the neck downwards. As a result, he is doubly incontinent and has no bladder control. Since his accident, he has had a suprapubic catheter, which is changed every four weeks by Rotherham’s continence team.

Jason has suffered recurrent urinary tract infections and also has post-catheterisation trauma. Over a seven-month period of using the new antimicrobial cleaning solution rather than a saline solution, Jason has had no urinary tract infections.


86 year-old Margaret has been living with multiple sclerosis for the last 20 years. With no mobility and doubly incontinent, she has had a urethral catheter for the past 10 years, which is changed every 12 weeks.

Like Jason, she has been free of urinary tract infections since swapping to the new solution and has no related unplanned hospital admissions.


The new solution is now used widely, particularly in community settings. While it is cost neutral when compared to saline solution pods, the reduction of both infection and expensive hospital admissions mean that the savings, while difficult to measure, are likely to be substantial.

The procurement process highlighted the value of the contribution of specialist nurses such as those working in IPC who were able to evaluate how products directly impacted patient outcomes.