Introduction: Frontline staff are frequently challenged by difficult urethral catheterization. This skill is usually acquired through exposure in clinical practice. This quality improvement project aimed to equip the frontline staff, such as registered nurses and licensed practical nurses, with the assessment of difficult urethral catheterization and improve their toolkit to successfully perform it.

Methods:  A pre-assessment survey was made to assess the knowledge, perception, and confidence to perform regular and difficult urethral catheterization. An educational video was developed about the difficult urethral catheterization, with recommendations to build on this skill. After the video, in-service staff completed the same survey for post-assessment purposes.

Results: There were 217 pre-surveys and 186 post-surveys included in the analysis; 27% of nursing staff rated themselves as "very confident" and 62% as "confident" to assess for difficult catheter post-video intervention compared to 11% and 45%, respectively, pre-ideo intervention (p<0.001). Similarly, an increase in confidence to choose for size and type of catheter based on the patient’s history has also increased from 45% to 67%(p<0.001). The perception of regular urethral catheter insertion skills and the confidence to perform the skill did not change significantly post-intervention.

Conclusions: The video education made a significant difference to improve the confidence and knowledge of nursing staff about difficult urethral catheterization. There was an increase in knowledge from 19% and 9% pre-video intervention to 73% and 90%, respectively, in two out of three areas mentioned in the survey post-video intervention. We have not seen a difference in perception to perform the regular catheterization. This video has already been widely used in various hospitals in Calgary, as well as at the provincial level to enhance frontline staff education.