Indhumathi Shanmugam
North Tees and Hartlepool NHS Foundation Trust, UKPresentation Title:
Audit of postpartum bladder care: Assessing practice and outcomes
Abstract
Postpartum urinary retention (PUR) is a well-recognised complication following childbirth, particularly after caesarean section. Prompt recognition and management are essential to prevent bladder overdistension, prolonged underactivity, urinary tract infections, overflow incontinence, and extended hospital stay.
Aim This audit evaluated compliance with our Trust’s bladder care policy and NICE standards for postpartum bladder care following caesarean section, with a focus on catheter removal timing, voiding monitoring, bladder volume assessment, and documentation quality.
Methodology This was a prospective audit. All women undergoing caesarean section over a one-month period (May 2025) were included, except those who opted out of data sharing (n=3). Data for 83 patients were collected using BadgerNet and TrackCare and analysed in Excel. Standards were derived from NICE guidance and the Trust’s bladder care policy.
Results: Catheter removal within 12 hours occurred in 16.8% (n=14), while 83.1% (n=69) experienced delays; reasons were documented in only four cases. First void was delayed (>6 h) in 12% (n=10), and voiding times were missing in 6% (n=5). First void volume <200 mL was recorded in 13.2% (n=11), with a further 13% (n=11) not documented. Of 19 women requiring bladder scans, only one was performed. No women required recatheterisation. Overall, documentation was incomplete in 36%, with acceptable records in 65.9% (n=60).
Conclusion: Compliance with Trust and NICE standards for postpartum bladder care after caesarean section was suboptimal. Delayed catheter removal, inadequate monitoring of voiding, lack of bladder scans, and incomplete documentation were key concerns. Planned actions include timely catheter removal once mobile, consistent documentation via the BadgerNet bladder care pathway, staff training in bladder scanning, and re-audit in 3 months to ensure sustained improvement.
Biography
Indhumathi shanmugam has completed a master's in Obstetrics and Gynaecology and is a member of the Royal College of Obstetricians and Gynaecologists. Dr.Indhumathi Shanmugam has worked as an Assistant Professor in various medical colleges and has been serving as a peer reviewer for PubMed-indexed journals."
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