Multidisciplinary Development and Implementation of a Trial of Void Algorithm to Standardize and Reduce Indwelling Urethral Catheter Use.

Autor:	Han DS; Department of Urology, Columbia University Irving Medical Center, New York, New York., Pingle SR; Department of Urology, Columbia University Irving Medical Center, New York, New York., Amolo LM; Department of Nursing, Columbia University Irving Medical Center, New York, New York., Roach ML; Department of Nursing, Columbia University Irving Medical Center, New York, New York., Luga MS; Department of Nursing, Columbia University Irving Medical Center, New York, New York., Layne SA; Department of Nursing, Columbia University Irving Medical Center, New York, New York., Veliz CR; Department of Nursing, Columbia University Irving Medical Center, New York, New York., Hurlbut L; Department of Nursing, Columbia University Irving Medical Center, New York, New York., Bennett B; Department of Nursing, Columbia University Irving Medical Center, New York, New York., Contreras H; Department of Nursing, Columbia University Irving Medical Center, New York, New York., Krishnamoorthy S; Department of General Surgery, Columbia University Irving Medical Center, New York, New York., Weiner DM; Department of Urology, Columbia University Irving Medical Center, New York, New York., Anderson CB; Department of Urology, Columbia University Irving Medical Center, New York, New York., Badalato GM; Department of Urology, Columbia University Irving Medical Center, New York, New York.
Jazyk:	angličtina
Zdroj:	Urology practice [Urol Pract] 2024 Sep; Vol. 11 (5), pp. 884-891. Date of Electronic Publication: 2024 Jun 19.
DOI:	10.1097/UPJ.0000000000000640
Abstrakt:	Introduction: Prolonged indwelling catheter use is a known risk factor for catheter-associated UTIs (CAUTIs). We sought to reduce catheter use by creating and implementing a trial of void (TOV) algorithm to standardize indwelling Foley catheter removal in surgical patients. Methods: We partnered with the Departments of General Surgery and Nursing to develop an evidence-based TOV algorithm for a step-down unit at a large urban teaching hospital. Our cohort included patients treated with intra-abdominal, thoracic, vascular, urologic, and gynecologic surgeries. The primary outcome was mean cumulative indwelling urethral catheter patient-days. For example, if 2 patients had catheters for 3 and 7 days, respectively, then cumulative catheter days would be 10. We analyzed changes in catheter use 90 days before and after algorithm implementation. Results: The mean number of hospitalized patient-days before and after algorithm introduction did not differ (32.2 vs 32.0, P = .60). After implementation, mean cumulative catheter patient-days decreased (14.8 vs 9.9, P < .01), as did mean daily number of patients with catheters on the unit (3.7 vs 3.1, P = .02). There was 1 CAUTI before and after algorithm implementation, the latter deemed associated with algorithm nonadherence. Catheter use in a surgical floor control group where the algorithm was not implemented did not differ for any outcome over the same time period ( P > .05). Conclusions: A multidisciplinary approach to standardize catheter care with a TOV algorithm is feasible and effective in reducing catheter use. Further research is needed to determine its impact on CAUTI rate.
Databáze:	MEDLINE
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