Addressing CAUTIs with an External Female Catheter.

BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) can lead to complications that prolong hospital stays and result in patient discomfort as well as increased health care costs and mortality. At our academic medical center in New York City, in 2016-17, 21 of 87 CAUTI cases (24%) were in bedbound female patients in whom indwelling catheters were used for incontinence. Although condom catheters were available as an alternative to indwelling urinary catheters for male patients, there was a lack of effective products for female patients. METHODS: A team of clinical nurse specialists (CNSs) conducted a literature search, reviewed internal data on CAUTI rates and catheter use, and searched for available catheter alternatives that would meet the needs of bedbound female patients. The team identified two different external female urinary catheters and piloted both with a focus on efficacy as well as stakeholder satisfaction. RESULTS: In 2019-20, external female catheters were used in 1,195 unique patients. Approximately 90% of external female catheter use was to avoid using an indwelling urinary catheter. With a cost avoidance of $13,786 per patient, $16,473,912 in costs to the organization were avoided. CAUTI rates in bedbound female patients decreased after implementation of the external female catheters. CONCLUSION: This initiative demonstrates that external female urinary catheters can be used at other hospitals to decrease indwelling urinary catheter use and CAUTI rates in bedbound female patients.

Opioid Misuse: An Organizational Response While Managing Cancer-Related Pain.

BACKGROUND: Opioids are commonly prescribed to manage cancer pain. Similar to the general population, patients with cancer are not excluded from the risk for opioid misuse and dependence. This situation can contribute to clinician reluctance to prescribe and manage pain using opioids. OBJECTIVES: The purpose of this article is to provide an overview of how opioid misuse may affect pain management in patients with cancer and to describe a comprehensive cancer center's approach to safely managing cancer pain. METHODS: Based on a literature review, the project team developed a stewardship program. Project components included selecting a validated screening tool for risk of opioid misuse, determining if a history of addiction affects pain management in patients with cancer, and establishing a task force to focus on the opioid crisis and to follow the Joint Commission's revised pain assessment and management standards. FINDINGS: The project established a hospitalwide opioid stewardship program. Through the use of a multidisciplinary, universal precautions approach to assessing misuse in all patients with cancer who are prescribed opioids, healthcare teams can potentially reduce risks associated with misuse while safely managing cancer pain.

Catheter-associated urinary tract infection prevention in the oncology population: an evidence-based approach.

Urinary catheters have been attributed to almost half of all healthcare-associated infections. Many catheter-associated urinary tract infections (CAUTIs) may be prevented by following recommended guidelines, which would save lives. This article illustrates the use of known guidelines for the prevention of CAUTIs in the oncology population.