Implementation of External Urine Collection Devices to Decrease the Standardized Utilization Ratio of Indwelling Urinary Catheters

Abstract

<h3>Background</h3> Catheter associated urinary tract infections (CAUTIs) are one of the most common hospital acquired infections. CAUTIs are associated with numerous complications including increased length of stay. The most significant risk factor for developing a CAUTI is the prolonged use of an indwelling catheter. Our purpose is to determine if the introduction of external urine collection devices for both male and female patients would impact the utilization of indwelling urinary catheters and subsequently, reduce our CAUTI events in our 24-bed Intensive Care Unit (ICU). <h3>Methods</h3> We established our baseline by measuring our urinary catheter utilization rate in our ICU for all 12-months in 2017. In June 2018, a qualitative trial was performed for three weeks for a female external device and then followed by the male external device. Prior to our trial, all team members were educated on the use of the external urine collection systems. Unit based Intensivists were updated on the product trial and encouraged to participate. During the trial, a light duty nurse rounded on each patient with an indwelling catheter to discuss the need for catheter necessity. If the patient required a device, it was advocated to remove the indwelling device and use an external device. Standardized Likert scale evaluations were completed by bedside nursing and nursing assistants during the trial. <h3>Results</h3> Based on the positive trial results, both products were implemented in the ICU and subsequently expanded hospital wide. Our baseline SUR for 2017 was 1.067. In 2018, our SUR decreased by 9.7% to 0.964. To date, our SUR data for January 2019 to October 2019 is 0.736. This is an overall 31% reduction in urinary catheter utilization from our baseline data. <h3>Conclusions</h3> In conjunction with daily conversations regarding catheter necessity, the implementation of external urine collection devices has significantly decreased the SUR on indwelling catheters.