Urinary catheter alleviation navigator protocol (UCANP): Update to the hospital-wide implementation at a single tertiary health care center

Abstract

Catheter-associated urinary tract infectionsare commonly reported healthcare-associated infections. It was demonstrated that the urinary catheter alleviation navigator protocol (UCANP) pilot resulted in a reduction of catheter utilization and catheter days. Quality improvement initiative that was implemented at a single urban, tertiary health care center, focusing on early discontinuation of indwelling urinary catheters (IUCs) and avoidance of reinsertion. The protocol was expanded hospital-wide fromSeptember 2020 to April 2022. We compared IUC utilization, IUC standardized utilization ratio (SUR), and catheter-associated urinary tract infection standardizedinfection ratio in the preintervention period (March 2020 to August 2020) to the postintervention period (May 2022 to October 2022). Preimplementation, 2 patients with IUC removal were placed on UCANP. Postimplementation, 835 (45%) patients with IUC removal participated in the protocol. The number of patients requiring IUC reinsertion did not differ among the 2 groups. IUC utilization was significantly decreased from 0.28 to 0.24 with a 14% reduction (P=.025). SUR decreased by 11% from 0.778 to 0.693 (P=.007) and standardizedinfection ratio by 84% from 0.311 to 0.049 (P=.009). Our protocol significantly reduced IUC utilization and SUR after hospital-wide implementation. UCANP is a safe and effective strategy that can potentially decrease unnecessary IUCs in patients with transient urinary retention.