Abstract: PD58-02
Sources of Funding: None

Introduction

Indwelling catheter placement is a modifiable risk factor for urethral trauma. We describe the various aspects of an educational system that was implemented at our hospital with the primary goal of reducing Foley catheter trauma.

Methods

A multidisciplinary Foley Project protocol was implemented in June 2015, which consisted of a system-wide catheter education program, difficult urinary catheterization (DUC) algorithm, and skilled catheter nursing (SCN) team to improve patient outcomes. The catheter education program consisted of a didactic presentation, supplemented with hands-on teaching, presented by urology residents. The DUC algorithm (Figure 1) provided nurses with step-by-step instructions to follow when a DUC is encountered. A retrospective review of male DUC consults between June 2014 and September 2015 was then performed. The pre-protocol group includes consults received from June 2014 to May 2015. The post-protocol group includes consults received from June 2015 to September 2015.

Results

There were 74 patients in the pre-protocol (median age 71 years, median BMI 26.0) and 18 patients in the post-protocol group (median age 75 years, median BMI 27.4). The overall incidence of catheter-associated trauma during placement was 30/71 (41.1%) in the pre-protocol and 1/17 (5.9%) in the post protocol groups (p=0.005). The total incidence of false passage in the pre and post-protocol groups was 19/73 (26.0%) and 0/17 (0%), respectively (p=0.02). In the pre-protocol group, 39/73 (53.4%) required a procedure by a urologist, while only 2/17 (11.8%) of patients in the post-protocol group required a procedure (p=0.002).

Conclusions

Implementation of a Foley Project protocol consisting of system-wide nursing education, DUC algorithm, and SCN team reduced the frequency of catheter-associated trauma and subsequent procedures.

Funding

None