As per the Centers for Disease Control and Prevention, patients with indwelling urinary catheters are at a higher risk of developing a hospital-acquired urinary tract infection known as catheter-associated urinary tract infection (CAUTI). These infections can cause discomfort and may extend the time patients stay in the hospital.
Removing these catheters as soon as possible after surgery helps to prevent CAUTI, and the CDC recommends that catheters be removed by the second day after surgery. At HSS, a multidisciplinary team was formed to revise and improve our processes for insuring that catheters are removed when they are no longer required.
We found that many patients were reluctant to have catheters removed because of the need to walk to the bathroom, so we began to educate patients pre-operatively about the need for catheter removal. We also investigated opportunities to improve the way catheters are ordered and developed a computerized order set for starting and discontinuing catheters.
All patients with urinary catheters are now assessed daily to gauge their necessity, and unnecessary catheters are removed promptly. Nursing also purchased handheld ultrasound bladder scanners, which measure the volume of urine in the bladder and help to prevent unnecessary re-catheterizations.
These actions have resulted in improved timely removal of urinary catheters, consistent with CDC guidelines.
*HSS, State, and National 2014 Average data collected from 2nd Quarter 2013 through 1st Quarter 2014.
HSS 2013 data collected from 1st Quarter through 4th Quarter 2013.
State and National 2013 Average data collected from 4th Quarter 2012 through 3rd Quarter 2013.
HSS, State, and National 2012 Average data collected from 1st Quarter through 4th Quarter 2012.
**Source for National and State Average data is Hospital Compare.
***Source for HSS 2012 and 2014 data is Hospital Compare. Source for HSS 2013 data is HSS internal monitoring.