Credentials of Corresponding Author
MSN, RN, APRN-CCNS, CCRN
Name of Faculty Advisor
Nature and scope of the project
To determine if the implementation of an evidence-based initiative that includes an educational program and an accompanying decision support tool enhances the effectiveness of an institution’s existing urinary catheter removal protocol by improving the nurses' ability to apply its concepts into practice, thereby facilitating earlier removal of unnecessary indwelling urinary catheters as compared to using the urinary catheter removal protocol alone.
Synthesis and analysis of supporting literature
Durant’s systematic review of the literature (2017) determined that nurse-driven catheter removal protocols have the potential to reduce the prevalence of CAUTI. Quinn et al. (2020) performed a qualitative study in a large progressive care unit in order to assess barriers to timely removal of indwelling catheters. A prominent feature of their findings was the lack of clarity, awareness, and agreement on appropriate reasons for maintaining an IUC, despite the availability of a list of appropriate indications. A lack of awareness of appropriate reasons to maintain an indwelling urinary catheter has regularly been identified in the project's target unit, despite the existence of a nurse-driven urinary catheter removal protocol that lists the acceptable and evidence-based reasons.
A decision support tool with established content validity has been developed by the investigator. After education on the appropriate reasons to maintain an indwelling urinary catheter, this tool will be utilized by the Registered Nurses in a Neuroscience ICU that has had confirmed opportunities for earlier removal of unnecessary catheters.
Comparison of pre- and post-intervention catheter utilization rates, Catheter-Associated Urinary Tract Infection rates, and nursing knowledge about the appropriate reasons to maintain an indwelling urinary catheter will be performed.
Desired outcomes of this project will be a reduction in catheter utilization; a reduction in Catheter-Associated Urinary Tract Infections; and, an increase in nursing knowledge about and application of the appropriate reasons to maintain an indwelling catheter.
Although the decision support tool that will be utilized during this project has been tailored to the suit the specific diseases and situations that may be found in a neuroscience ICU population, the tool still has great potential for generalizability. Engagement from all stakeholders will be critical to the success of this change project.
Enhancing the Effectiveness of a Nurse-Driven Indwelling Urinary Catheter Removal Protocol through the Implementation of a Decision Support Initiative