RESUMEN
BACKGROUND: Surgeons use indwelling bladder catheters (IBCs) to avoid urinary retention in patients with epidural analgesic catheters. Reduction of IBC-days is associated with improved catheter-associated urinary tract infection rates (CAUTI). This study investigates real world application of a Nurse-Driven Catheter Removal Protocol (NDCRP) to reduce IBC-days in this patient population. METHODS: Patients with epidural catheters and IBC were targeted for IBC removal on post-operative day 1 (POD1). Patients were followed for application of the NDCRP, catheterization need, IBC re-anchoring, and complications. RESULTS: One hundred and thirty-three patients had IBCs removed on POD1 (Protocol Group) and 50 patients did not (Non-Protocol Group). There was a reduction in IBC-days in the Protocol Group despite incomplete adherence to the NDCRP (1.55 days vs 4.64 days; P < .001). Ninety-three patients (70%) were able to spontaneously void after early IBC removal. Fourteen patients (11%) were able to spontaneously void after serial in-and-out catheterization (I/O). No significant difference in re-anchoring was found between the protocol and non-protocol groups (26 vs 4 patients; P = .09). CONCLUSIONS: Early removal of IBCs (POD1) in patients with epidural catheters with the assistance of an NDCRP is a safe and successful strategy to reduce IBC-days in the hospital.
Asunto(s)
Catéteres Urinarios , Infecciones Urinarias , Catéteres de Permanencia/efectos adversos , Remoción de Dispositivos/efectos adversos , Humanos , Dolor/complicaciones , Cateterismo Urinario/efectos adversos , Catéteres Urinarios/efectos adversos , Infecciones Urinarias/etiologíaRESUMEN
An interprofessional practice gap was identified in relation to discharge care provided to patients with tracheostomies or laryngectomies. Using a case study method, this article presents an approach that administrators of educational programs can take to develop an instructive strategy to address the practice gap and improve patient care.
