Improving Patient Outcomes and Health Care Provider Communication with a Small, Yellow Plastic Band: the Patient URinary Catheter Extraction (PURCE) Protocol©.

ABSTRACT

INTRODUCTION: Great efforts are being made to reduce catheter associated urinary tract infections as they increase patient morbidity and are costly to health care centers. Although various catheter associated urinary tract infection prevention initiatives exist, efficient communication between physicians and nurses continues to be a significant barrier. In an effort to enhance communication and reduce catheter associated urinary tract infections, we implemented a novel Patient URinary Catheter Extraction (PURCE) Protocol© and in this study we evaluate the utility of the PURCE Protocol. METHODS: The PURCE Protocol was implemented for all urology and vascular surgical patients admitted to 1 surgical specialty unit between January and December 2014 (treatment group, 901 patients). The control group consisted of urology and vascular surgical patients admitted to the same surgical specialty unit during the 12-month period (January to December 2013) before protocol implementation (926). End points included annual catheter associated urinary tract infection rates, device utilization ratio and protocol deviations. RESULTS: The majority of urology/vascular surgery patients in both groups underwent catheter placement (control 55.4% vs treatment 58.9%). The annual catheter associated urinary tract infection rate for urology/vascular surgery patients in the control group was 2.5 compared to 0.0 in the treatment group. The annual device utilization ratio increased slightly from 0.15 in the control to 0.17 in the treatment group. Within the first 6 months of implementation there were 405 patient audits and 28 protocol deviations (6.9%), and no additional deviations occurred in the last 6 months of the study. CONCLUSIONS: According to our findings implementation of the PURCE Protocol led to a reduction in catheter associated urinary tract infections in a highly susceptible surgical patient population.