Who Changes Indwelling Urinary Catheters in Male Nursing Home Residents and Where? Results from a Nationwide Cross-Sectional Survey in Germany

Introduction: We examined the practice and variability of indwelling urinary catheter changes in male nursing home residents. Methods: Cross-sectional data from a nationwide survey conducted in a representative sample of German nursing homes in 2023 were analyzed. The professions conducting most transurethral/suprapubic catheter changes in men were identified, and proportions for whom respective catheters are changed in nursing homes were determined. Associations between these proportions and nursing home characteristics were investigated via multivariable logistic regressions. Results: Of 1,369 invited facilities, 330 (24.1%) participated. Urologists changed most catheters in 72.8% (transurethral catheters) and 88.3% (suprapubic catheters) of the facilities. The median proportion of men whose catheters were changed in nursing homes was 8.5% (transurethral catheters; interquartile range 0.6%-100.0%) and 1.0% (suprapubic catheters; interquartile range 0.0-100.0%). Facilities in which urologists changed most catheters were less likely to have a high proportion (>= 90%) of in-home catheter changes compared to the reference group (odds ratio 0.44 [transurethral catheters; 95% confidence interval 0.24-0.82] and 0.30 [suprapubic catheters; 0.12-0.76]). Conclusion: The proportion of men whose catheters were changed in nursing homes varied considerably between facilities and was lower where urologists were involved.