Outcomes of a Nurse-Led Difficult Urinary Catheter Team in an Academic Medical Center

摘要

Background: Catheter insertion for complex patients by inexperienced nurses can lead to avoidable iatrogenic urethral injury and catheter-associated urinary tract infection (CAUTI). Purpose: The study aim was to evaluate a comprehensive nurse-led difficult urinary catheterization (DUC) Program to reduce patient CAUTIs. Methods: A retrospective cohort study design was used to evaluate the DUC Program's effectiveness during 2013 to 2017. Measures included RN DUC consultations, protocol adherence, patient CAUTIs, and urology consults. Results: The RN DUC team consulted 435 patients with a 92% insertion success rate. The DUC protocol adherence was 66.1%. Patient CAUTIs decreased from baseline (169) to year 4 (24) (odds ratio: 0.1889, 95% confidence interval = 0.1231-0.2898,P< .001). Urology consults decreased from baseline (40) to year 3 (21), however, increased in year 4 (80) when a urology residency program was started. Conclusion: This comprehensive program was effective in improving catheter insertion technique, eliminating urology consults, and reducing CAUTIs when combined with organizational prevention measures.