Abstract
Background: Traumatic urethral catheterization is a common reason for urologic consultation in hospitalized patients. The purpose of this study was to determine if a protocol designed to decrease Foley catheter use was effective and if implementation of the protocol decreased the incidence of Foley catheter–associated trauma.Methods: In an effort to decrease catheter use, our institution adopted a nurse-driven Foley catheter protocol in May 2015 that allowed nurses to remove Foley catheters that did not meet criteria. We conducted a retrospective medical records review of patients who had Foley catheter–associated trauma occurring between February 2013 and March 2018 and compiled data concerning Foley catheter use. Using t test statistical analysis, we compared rates of Foley catheter use and Foley catheter–associated trauma before and after protocol implementation.Results: During the 62-month study period, we documented 83 cases of Foley catheter–associated trauma. Prior to protocol implementation, our institution had mean of 2,903 patient-catheterization days per month. Following protocol implementation, the mean decreased to 2,604 patient-catheterization days per month (P<0.01). Prior to protocol implementation, the mean incidence of Foley catheter–associated trauma was 1.81 traumas per month. Following protocol implementation, the mean incidence decreased to 0.97 trauma per month (P<0.05).Conclusion: Implementation of the protocol was successful in decreasing Foley catheter use as well as Foley catheter–associated trauma.
Highlights
Traumatic urethral catheterization is a common reason for urologic consultation in hospitalized patients
The urology service compiled a list of consultations for Foley catheter–associated traumas occurring between February 2013 and March 2018
In 68 of 83 (82%) cases, the trauma occurred during catheter insertion, and in 15 of 83 cases (18%), the trauma occurred when patients removed the catheter with the balloon inflated
Summary
Traumatic urethral catheterization is a common reason for urologic consultation in hospitalized patients. In the protocol, approved indications for Foley catheterization included urinary retention, nonhealing sacral or perineal wound, required immobilization, hospice/comfort care, critically ill patient in the intensive care unit (ICU) requiring intensive monitoring, chronic indwelling Foley catheter on admission, or any Foley catheter placed or ordered by the urology service. These criteria limit the number of Foley catheters that can be placed. Conclusion: Implementation of the protocol was successful in decreasing Foley catheter use as well as Foley catheter–associated trauma
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