MP06-09 NOVEL ALGORITHM FOR INDWELLING URINARY CATHETER REMOVAL: A PILOT STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP06-09 NOVEL ALGORITHM FOR INDWELLING URINARY CATHETER REMOVAL: A PILOT STUDY Emmett H Kennady, Kathleen Rea, Priyanka R Kumar, Dayna Monaghan, David E Rapp, Haerin Beller, and Emmett Kennady Emmett H KennadyEmmett H Kennady More articles by this author , Kathleen ReaKathleen Rea More articles by this author , Priyanka R KumarPriyanka R Kumar More articles by this author , Dayna MonaghanDayna Monaghan More articles by this author , David E RappDavid E Rapp More articles by this author , Haerin BellerHaerin Beller More articles by this author , and Emmett KennadyEmmett Kennady More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003217.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Indwelling urinary catheter (IUC) complications including catheter-associated urinary tract infection (CAUTI) are a major source of patient morbidity associated with increased mortality and healthcare costs. Although urinary retention following IUC removal can lead to complications including CAUTI, no well-established algorithms exist for management following IUC removal. The objective of this study was to evaluate the impact of a comprehensive IUC removal algorithm. We hypothesized that a protocol driven approach to urinary retention would be superior to routine care. METHODS: A data-driven IUC removal algorithm was developed by a multidisciplinary team (Figure 1). This was made available via Epic order-set. All patients cared for in the neurosciences units in the first 3 months following implementation (April – July 2022) were evaluated. Patients were stratified by use of the algorithm. RESULTS: A total of 450 patients were evaluated during the study period. Following best of fit matching for length of stay, there were 189 patients in each cohort. There were largely no differences in baseline characteristics between algorithm and no algorithm groups, respectively (age 64 vs 64, p=0.455; BMI 28.58 vs 28.49; p=0.243). There were no CAUTIs in either group. Although the algorithm group had a significantly higher number of in-and-out catheterizations (430 vs 360; p=0.010) and bladder scans performed (826 vs 572; p=0.003), this led to a significant reduction in the proportion of patients discharged with indwelling catheters (4.3% vs 16.9%; p<0.001). There was no difference in the median time with IUC between groups (1.29 vs 1.09 days; p=0.435). There was only one consult for urinary retention in the algorithm group compared to five in the no-algorithm group (p=0.10). CONCLUSIONS: Implementation of a urinary retention algorithm following IUC removal is associated with a decrease in the number of patients discharged with an IUC. Furthermore, this algorithm may increase non-urologic clinicians’ independence in managing urinary retention. This novel algorithm was feasible and effective in a neuroscience patient population and these data warrant broader application. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e56 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emmett H Kennady More articles by this author Kathleen Rea More articles by this author Priyanka R Kumar More articles by this author Dayna Monaghan More articles by this author David E Rapp More articles by this author Haerin Beller More articles by this author Emmett Kennady More articles by this author Expand All Advertisement PDF downloadLoading ...