Multi-disciplinary development and implementation of a trial of void algorithm to reduce indwelling urethral catheter use

You have accessJournal of UrologyCME1 Apr 2023LBA01-07 MULTI-DISCIPLINARY DEVELOPMENT AND IMPLEMENTATION OF A TRIAL OF VOID ALGORITHM TO REDUCE INDWELLING URETHRAL CATHETER USE David Han, Lovie Amolo, Hersy Contreras, Maureen Lowers Roach, Bridgette Bennett, Maria Sofia Luga, Shelly-Anne Layne, Coraima Rihan Veliz, Subhash Krishnamoorthy, David Weiner, Christopher Anderson, and Gina Badalato David HanDavid Han More articles by this author , Lovie AmoloLovie Amolo More articles by this author , Hersy ContrerasHersy Contreras More articles by this author , Maureen Lowers RoachMaureen Lowers Roach More articles by this author , Bridgette BennettBridgette Bennett More articles by this author , Maria Sofia LugaMaria Sofia Luga More articles by this author , Shelly-Anne LayneShelly-Anne Layne More articles by this author , Coraima Rihan VelizCoraima Rihan Veliz More articles by this author , Subhash KrishnamoorthySubhash Krishnamoorthy More articles by this author , David WeinerDavid Weiner More articles by this author , Christopher AndersonChristopher Anderson More articles by this author , and Gina BadalatoGina Badalato More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003360.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prolonged indwelling catheter use is a risk factor for catheter-associated urinary tract infections (CAUTIs). To reduce catheter use among post-operative patients, we sought to create and implement a novel algorithm to standardize the removal of indwelling Foley catheters. METHODS: We partnered with nursing leadership and the General Surgery Department to develop an evidence-based trial of void algorithm for a surgical Step-Down Unit at an urban teaching hospital [Figure 1A]. Our cohort included post-operative patients treated with intraabdominal, thoracic, vascular, and gynecologic surgeries; patients having urologic surgeries with an imperative indication for a long-term indwelling urethral catheter were excluded from the algorithm but included in analysis. The primary outcome was mean cumulative indwelling urethral catheter days (ex. if 2 patients had catheters for 3 and 7 days, then cumulative catheter days would be 10). We also measured mean total patient days (as a surrogate for patient volume), mean daily number of patients with catheters, and the number of CAUTIs, which are all nationally reported outcomes from the Centers for Disease Control and Prevention. Another surgical unit where the algorithm was not implemented was used as a natural control. We analyzed changes in relevant outcomes 90 days before and after algorithm implementation. RESULTS: The mean number of hospitalized patient days before and after algorithm introduction did not differ on the Step-Down Unit (32.2 vs. 32.0, p=0.60). After implementation, mean cumulative catheter days decreased (14.8 vs. 9.9, p<0.01), as did mean daily number of patients with catheters (3.7 vs. 3.1, p=0.02). Measures of catheter use variation also decreased [Figure 1B]. There was one CAUTI before and after algorithm implementation, the latter deemed potentially associated with algorithm non-adherence on root cause analysis. Measures of catheter use in the surgical floor control group did not differ for any outcome (p>0.05) over the same time-period. CONCLUSIONS: A multi-disciplinary approach to standardize catheter care with an evidence-based trial of void algorithm is feasible and effective in reducing catheter use. Further expansion of this pilot is needed to establish an impact on the associated rate of CAUTI. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1178 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Han More articles by this author Lovie Amolo More articles by this author Hersy Contreras More articles by this author Maureen Lowers Roach More articles by this author Bridgette Bennett More articles by this author Maria Sofia Luga More articles by this author Shelly-Anne Layne More articles by this author Coraima Rihan Veliz More articles by this author Subhash Krishnamoorthy More articles by this author David Weiner More articles by this author Christopher Anderson More articles by this author Gina Badalato More articles by this author Expand All Advertisement PDF downloadLoading ...