Urinary Catheter Care Research Articles

Relationship between Frequency of Urinary Catheter Care and Incidence of Urinary Tract Infection (UTI) in KH Ahmad Dahlan Room, RSU Muhammadiyah Ponorogo

Urinary tract infection (UTI) is a frequent occurrence in hospitals and it was reported that 37% of inpatients at RSU Muhammadiyah Ponorogo were fitted with urinary catheters and 38% of them experienced UTI. Frequency of urinary catheter care could potentially affect the incidence of UTI. This study aims to determine the relationship between the frequency of urinary catheter care and the incidence of urinary tract infection (UTI) in the KH Ahmad Dahlan Room of RSU Muhammadiyah Ponorogo. This research method is quantitative with a correlational design using a Cross Sectional approach. The study population was all inpatients in the KH Ahmad Dahlan Room at RSU Muhammadiyah Ponorogo in September - October 2023 totaling 484 patients with an average of 242 people / month. The sampling technique used purposive sampling with the research sample being a portion of inpatients with catheters installed, totaling 30 respondents. Data collection using Check List. Data analysis techniques using Chi-Square. The results of this study showed that of the 30 respondents, most of the 28 respondents (93.33%) with the frequency of urinary catheter care were irregular (not every day) and most of the 29 respondents (96.67%) experienced the incidence of urinary tract infections (UTI). The results of the Chi-Square statistical test obtained a p-value obtained of 0.095> 0.05 so as not to reject H0 which means there is no significant relationship between the frequency of urinary catheter care and the incidence of urinary tract infection (UTI).

Contributing Factors to Central Line-associated Bloodstream Infections and Catheter-associated Urinary Tract Infections

Background: Central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) are key healthcare-associated infection (HAI) quality metrics. In this qualitative analysis, we aimed to identify common issues contributing to CLABSIs and CAUTIs occurring during the COVID-19 pandemic. Methods: In an academic healthcare network in Atlanta, GA, four hospitals perform real-time, apparent cause analyses (ACAs) for all CLABSIs and CAUTIs. Contributing factors are entered as free text into an electronic database. We analyzed data from 8/2020–8/2022. We first performed a qualitative open card sort of all reported contributing factors to CLABSI and created a novel framework based on mutually defined critical tasks (e.g., line insertion) and cross-cutting issues (e.g., communication breakdown). Contributing factors could describe ≥1 critical task and/or ≥1 cross-cutting issue. After establishing interrater reliability, a multidisciplinary group applied this framework to classify each contributing factor. For CAUTI, we used the same set of cross-cutting issues but identified new critical tasks via open card sorting. We then used the framework to classify each CAUTI contributing factor. We used descriptive statistics to identify frequent critical tasks and cross-cutting issues. Results: We reviewed 350 CLABSI ACAs with 602 contributing factors and 240 CAUTI ACAs with 405 contributing factors (Figure 1). Our classification framework comprised 11 cross-cutting issues and 9 critical tasks for CLABSI and 7 critical tasks for CAUTI (Figure 2). CLABSI: The critical tasks most often reported were bathing (19%), central line dressing maintenance (15%), and assessing central line indication (8%; Figure 3). Within these tasks, the most frequent issues described for bathing were the task not being performed (20%) and unclear documentation (18%); for dressing maintenance, the task was not performed (15%), not documented (15%), or poorly performed due to lack of competency (15%); and for assessing line indication, there was frequent communication breakdown (33%). CAUTI: The critical tasks most often reported were urinary catheter care (26%) and assessing the indication for urinary catheter (22%; Figure 4). Within these tasks, urinary catheter care was frequently not documented (38%) or not performed (16%); assessing urinary catheter necessity was often not documented (29%) or involved breakdown of communication (19%). Conclusion: We created a novel framework to evaluate common causes of HAIs in an academic healthcare network. This framework can be used to identify and track gaps over time and to develop quality improvement initiatives targeting key tasks and associated factors, such as communication difficulties when assessing device indications.Disclosure: Colleen Kraft: Consultant - REbiotix/Ferring; Scientific Advisory Board - Seres, LLC

Candida parapsilosis candidemia in children admitted to a tertiary hospital in Turkey: clinical features and antifungal susceptibility.

It has been observed that the frequency and antifungal resistance of Candida parapsilosis have increased recently. In our study, we aimed to determine the antifungal sensitivity of C. parapsilosis and the clinical and demographic characteristics of children with candidemia. It was observed that the patients' history of malignancy, mechanical ventilation, urinary catheter, nasogastric tube, and intensive care stay was associated with C. parapsilosis mortality. The mortality rate from candidemia was 9.5%. The most frequently preferred antifungal agents were amphotericin B and fluconazole. The fluconazole drug resistance rate was found to be 6%, and the amphotericin B drug resistance rate was 4%. Because C. parapsilosis candidemia mortality rates can be high depending on risk factors and clinical characteristics, it is important to initiate appropriate and timely antifungal therapy.

Perioperative Nursing Considerations for Transurethral Resection Prostatectomy

The present article was an overview of transurethral resection prostatectomy (TURP) and its prevalence, emphasizing the critical role of perioperative nursing in enhancing patient safety and outcomes. Preoperative nursing assessment was explored, covering the importance of patient history and risk assessment, diagnostic tests and evaluations, patient counseling, and informed consent, as well as preoperative optimization and preparation. The intraoperative nursing management section outlines key responsibilities in setting up the operating room, maintaining infection control, preventing specific clinical risk of TURP, managing anesthesia, ensuring surgical team coordination and communication, and adhering to evidence-based guidelines. Postoperative nursing care focused on immediate recovery and monitoring, pain management strategies, urinary catheter care, early ambulation, complication prevention, and patient education. Emerging trends and innovations in perioperative nursing were discussed, including advancements in surgical techniques, integration of new technologies, telemedicine, and the adoption of holistic care approaches. The present article also addressed the challenges facing perioperative nurses, such as workforce shortages and burnout, research gaps in TURP nursing, and the importance of promoting ongoing education and training. By examining these key elements, the present article provided a comprehensive resource for perioperative nurses, healthcare providers, and researchers, aimed to enhance understanding, improved patient care, and stimulated further advancements in the field.

Perawatan Kateter Urine Dengan Chlorhexidine Gluconate 5% dalam Mencegah Infeksi Saluran Kemih

Background: Urinary tract infections that occur in hospitals are mostly caused by the installation of indwelling urinary catheters. Indwelling urinary catheter care is one way to prevent catheter-related urinary tract infections. Objective: This study aims to determine the effect of indwelling urinary catheter treatment using 5% chlorhexidine gluconate on urinary tract infections in the Blora Hospital. Methods: This research uses a quasi-experimental posttest-only design. The sampling technique was purposive sampling, 12 subjects were recruited. The independent variable is indwelling urinary catheter care, and the dependent variable is urinary tract infection. Data were collected using colony counts and bacterial types on the fourth day. Data were analyzed by using the Mann Whitney test. Results: The results of the study showed that there was no difference in the incidence of urinary tract infections between patients in the treatment group who received indwelling urinary catheter treatment using chlorhexidine gluconate 5% and patients in the control group who received standard catheter treatment (p=0.138). Conclusion: Perineal care agents do not affect the incidence of catheter-related urinary tract infections. Further research should involve a larger number of respondents and consider respondent characteristics such as antibiotic use, diabetes mellitus, and urine production to obtain more accurate results.

Knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter

Objectives: The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter. Materials and Methods: This cross-sectional study was conducted from June 1, 2021, to September 11, 2021, in a tertiary hospital in north India. Purposive sampling was used to select 50 participants. Three instruments were employed for data collection after fulfilling sample criteria; for baseline information demographic tool, knowledge questionnaires, and a practice checklist. Data were analyzed using descriptive and inferential statistics. Results: On assessment of 50 participants, the majority of parents aged above 30 years (74%). Most of the participants were male (82%), graduated (38%), and working in the private sector (58%). Similarly, two-thirds of participants were residing in a nuclear family (64%) with a single child 32 (64%) and family income <5000 rupees per month (60%). The mean score of knowledge was 1.94 ± 0.81 and that of practice skills was 1.98 ± 0.85 on home-based care. Regression analysis showed that knowledge of parents was significantly associated with qualification (β: 1.821, P = 0.002). Similarly, association of practice skills of parents with gender (β: 1.235, P = 0.050) and qualification (β: 1.889,P = 0.00) was significant. Conclusion: The general findings of our study showed that parents’ education and occupation played a significant role in a child’s care. Parental education and catheter care skills positively affect the child and reduce readmission rates.

Community Intervention Team Management of Urology patients in the Community

Introduction: Urinary catheters are a necessary and frequent intervention in the acute clinical setting but can be successfully implemented in a patient’s home with the appropriate protocols. Caredoc Community Intervention Teams (CIT) work closely with local hospitals to establish structured, streamlined referral pathways for patients requiring catheterisation to be managed in the community, thus reducing hospital admissions and visits. Caredoc CIT nurses have been equipped with the requisite skills to successfully manage urology patients, many who are post-operative, outside of the hospital setting, ensuring that this cohort can be managed safely at home with the support of family and/or carers.
 Aims, Objectives, Theory Or Methods: The purpose of the CIT urology pathway is to provide rapid acute nursing care interventions to patients in their own homes. Patients are identified by urology consultants at local hospitals or by their GPs and referred to CIT for a period of continuous care, with home visits carried out by specialist nurses during a defined timeframe. This facilitates both early hospital discharge and admission avoidance as well as reducing waiting lists for outpatient ambulatory and scheduled care. This shared care initiative aims to transition vital urinary catheter care to the community resulting in a person-centred approach that keeps discharged patients comfortable and well in their own environment.
 Highlights Or Results Or Key Findings: Patients are managed safely in their own homes by the CIT Team for the duration of their ongoing treatment. By providing a spectrum of catheter care and education, such as teaching patients on the colour of their urinary output, how and when to empty their drainage bag and how to use a fluid balance sheet to record volume emptied, patients are given the knowledge to monitor their urinary output and are enabled to recognise potential red flags for infection and any catheter-related issues that may debilitate or affect their quality of life, with a particular emphasis on the prevention of sepsis in older patients. 24-hour catheter care support is offered by way of a telephone line for patients and their carers should they need advice - prior to the instantiation of the CIT service, patients with subrapubic catheters in residential care or who sought care in the out-of-hours were referred to emergency department via ambulance transfer, as the specialism required for management of these patients was not otherwise available.
 Conclusions: The CIT Team have successfully demonstrated integrated care pathways for managing patients requiring catheterisation in the community, leading to positive patient outcomes and experiences as well as having a significant impact on urology waiting lists and emergency department attendances. 
 Implications For Applicability/Transferability, Sustainability And Limitations: Sustainability of this process is guided by an integrated, systematic approach to proactive care of people who require catheter care at home, with the aim to improve delivery methods, reduce the burden on acute hospitals and achieve better patient outcomes.

Urinary Catheterization and Care of Urinary Catheter

Catheter-associated urinary tract infection (CAUTI) is usually defined as a UTI in a patient with current urinary tract catheterization or who has been catheterized in the past 48 hours. Urinary tract infections are the most common type of healthcare-associated infection, accounting for more than 30% of infections reported by acute care hospitals. National data from NHSN acute care hospitals in 2006 showed a range of pooled mean CAUTI rates of 3.1- 7.5 infections per 1000 catheter-days. Urinary catheters increase the risk of acquiring CAUTI; thus health care personnel must take special care to minimize that risk. Health care workers should follow evidence-based guidelines, including using aseptic technique for site preparation and supplies and limiting use and duration of the placement of urinary catheters.

Teaching Time: Postoperative Urinary Catheter Care in the Preoperative Setting Before Surgery

Teaching Time: Postoperative Urinary Catheter Care in the Preoperative Setting Before Surgery

Barriers to Implementation of a Urinary Catheter Care Bundle for Critically Ill Patients with Cerebrovascular Stroke

Barriers to Implementation of a Urinary Catheter Care Bundle for Critically Ill Patients with Cerebrovascular Stroke

The epidemiology of carbapenem-resistant Enterobacterales in a single center in Oman

Background: Carbapenem-resistant Enterobacterales (CRE) are a global public health threat associated with significant morbidity and mortality. Objectives: The study aims to describe the epidemiology, microbiology and outcome of patients with CRE infection or colonization during an active surveillance program and to determine the risk factors for the acquisition of such organisms in a single center in Oman. Method: A retrospective case–control study was conducted in a tertiary care hospital in 2015 and 2016. Cases included patients who had a positive screening or clinical sample for CRE and controls included patients who were screened during the same period and never had a positive screening or clinical sample for CRE. Risk factors analyzed were demographics, comorbidities, instrumentation, and antibiotic exposures. Data were analyzed using SPSS for Windows (version 11.5). Variables of interest were analyzed by univariate analysis, and those of significance were analyzed by logistic regression. Results: Seven hundred and twenty-eight cases were detected from active surveillance screening, and clinical samples and 749 controls were included. Males comprised 417 (57.3%) cases and females 311 (42.7%). The majority of CRE cases were adult patients (88%, n = 644) compared to 12 % (n = 84) paediatric. The total number of CRE screenings was 8,431 samples in 2015 with a positivity rate of 4.2% and 10,231 samples in 2016 with a positivity rate of 3.6%. The annual incidence rate of CRE was 0.8 per 100 admissions in 2015 and 0.76 per 100 admissions in 2016. The annual incidence density was 1.90 and 1.89 per 1000 patient days for both years, respectively. Healthcare-associated acquisition was 99.5%, and only 0.5% was attributed to the community. The most common sites of infections were urine and wound comprising 29% each. Klebsiella pneumoniae (n = 578, 79%) was the predominant organism followed by Escherichia coli (n = 101, 14%). CRE acquisition was significantly associated with the presence of a urinary catheter (odds ratio [OR]: 7.3; confidence interval [CI]: 4.6–11.6; P < 0.0001 or central line (OR: 3.5; CI: 2.068–6.011; P < 0.001), intubation (OR: 0.5; CI: 0.264–0.947; P < 0.034), antibiotic exposure (OR: 4.5; CI: 3.101–6.586; P < 0.0001), and intensive care unit (ICU) admission (OR: 0.5; CI: 0.297–0.852; P = 0.011). In addition, history of a local and an abroad hospital admission significantly increased the risk of CRE acquisition (respectively, local OR: 10.97; CI: 7.878–15.301; P < 0.000, abroad OR: 12.4; CI: 6.597–23.617; P < 0.0001). Overall mortality was 23.1 and 52.3% among bacteremia cases. Conclusion: The annual incidence of CRE acquisition is high with a high mortality rate. A multifaceted strategy to control the spread of CRE is fundamental, considering the specific epidemiology of CRE related to our institution and country.

Implementation of Standardized Catheter Cleansing Cloths at an Inpatient Rehab Facility

<h3>Background</h3> A higher than expected number of catheter-associated urinary tract infections (CAUTIs) was occurring at an inpatient rehab facility (IRF). Patients at IRFs often have indwelling urinary catheters (IUCs) for medical conditions like neurogenic bladder or urinary retention conditions. It is essential to provide consistent care and maintenance of IUCs for patients with long-term or chronic urinary catheters to prevent infection. Variability exists in the frequency, procedure, and availability of products for catheter care. <h3>Methods</h3> The quality improvement project, using lean methodology, took place over a six-month period at a 38 bed IRF to include patients with an IUC. The catheter cleansing cloths were used daily and as needed on patients with an IUC. The improvement project assessed if the daily use of the catheter cleansing cloths reduced the incidence of CAUTI at an IRF. A daily tracking tool was developed to monitor catheter device utilization and record daily documentation of urinary catheter care with the designated cleansing cloths. <h3>Results</h3> In the 12 months prior to the implementation of the catheter cleansing cloths, the IRF had seven CAUTIs. In the six months since the start of using the cloths, the IRF had zero CAUTIs. The Standardized Utilization Ratio (SUR) for the IRF in the six months prior to implementing daily device monitoring was 1.458. In the first six months of daily device monitoring, the SUR was 1.014. <h3>Conclusions</h3> The quality improvement project revealed a standardized process for daily catheter care is associated with a reduction in CAUTI. This project also notes an association between the daily monitoring of IUC devices and a reduction in catheter device utilization. Using catheter cleansing cloths for daily catheter care may be a great resource to provide consistent and predicable care for patients with IUCs.

Effectiveness of implementing a preventive urinary catheter care bundle in hip fracture patients.

BackgroundUrinary catheter (UC)–associated infections are one of the most common preventable healthcare-associated infections (HAIs) and they frequently occur in older, frail populations.AimThe study aim was to describe the incidence of UC-associated infection in elderly patients undergoing hip fracture surgery after implementing a preventive care bundle.MethodsA longitudinal prospective study using a before-and-after design. The bundle was theory driven and involved the co-creation of a standard operational procedure, education and practical training sessions. Prospectively collected registry data were analysed. Univariable statistics and multivariable logistic regressions were used for analyses.Results2,408 patients with an acute hip fracture were included into the study. There was an overall reduction in UC catheter associated-associated urinary tract infections, from 18.5% (n = 75/406) over time to 4.2% (n = 27/647). When adjusting for all identified confounders, patients in phase 4 were 74% less likely to contract an UC-associated infection (OR, 0.26; 95% CI, 0.15–0.45, p < 0.0001).DiscussionBundled interventions can reduce UC-associated infections substantially, even in elderly frail patients. Partnership and co-creation as implementation strategies appear to be promising in the fight against HAI.

The effect of urinary catheter care bundle compliance on catheter-associated urinary tract infections

The effect of urinary catheter care bundle compliance on catheter-associated urinary tract infections

Unilateral anal sacculectomy for anal sac apocrine gland adenocarcinoma with urethral involvement

The patient presented to a veterinary hospital with a month-long history of ‘scooting’ and a right-sided anal gland mass. A diagnosis of a stage 2 anal sac apocrine gland adenocarcinoma was confirmed, and the patient underwent a right-sided anal sacculectomy. There was involvement of the urethra and adherence to the rectum and a subsequent urethral incision was necessary, which was surgically repaired at the time of surgery. The patient was hospitalised for several weeks postoperatively for urinary catheter care and further nursing interventions. The patient was discharged from hospital 3 weeks after surgery once the urethra had healed sufficiently enough to enable normal micturition and subsequently made a full recovery.

Patient and Family Engagement in Catheter-Associated Urinary Tract Infection (CAUTI) Prevention: A Systematic Review.

Catheter-associated urinary tract infections (CAUTIs) are detrimental to health and are largely preventable with adherence to CAUTI prevention guidelines. Patient and family engagement in CAUTI prevention is often encouraged in these guidelines; however, little is known about how this engagement is operationalized in practice. A systematic review was conducted to synthesize the content, format, and outcomes of interventions that engage patients and/or families in CAUTI prevention. Two reviewers independently screened records from four databases up to March 2021 and searched reference lists of final articles. Included articles were primary research, tested an intervention, involved indwelling urinary catheters, and described at least one patient and/or family engagement method. Articles were appraised for quality using the Downs and Black checklist. After 720 records were screened, 12 were included. Study quality ranged from good to poor, scoring lowest in internal validity. The most common formats of patient/family engagement were flyers/handouts (83.3%) and verbal education (58.3%). Common content areas were urinary catheter care and maintenance strategies. Most study outcomes (83.3%) measured CAUTI rates, and half measured patient/family-related outcomes. Improvements were seen in at least one outcome across all studies, but less than half (41.7%) showed statistically significant results. The researchers found that most interventions lacked sufficient detail on the content, delivery, and/or outcome measurement of patient/family engagement, which limits transferability. More high-quality, generalizable trials are warranted in this area. Future research should focus on integrating publicly available resources into practice that can be tested for comprehension and revised based on feedback from target audiences.

Knowledge, attitude and practice in relation to catheter-associated urinary tract infection (CAUTI) prevention: A cross-sectional study.

Healthcare-associated infection (HAI) is one of the major threats to patients' safety besides being among the principal causes of patient morbidity and mortality. Catheter-associated urinary tract infection (CAUTI) is reported to be the most common HAI worldwide. CAUTI can be prevented with appropriate practice and care by healthcare personnel, especially nurses, who play the main role in urinary catheter care. Nurses' knowledge and attitude are considered to be important factors that influence their practice. To assess nurses' level of knowledge, attitude and perceived practice regarding CAUTI and its preventive measures. A cross-sectional design was adopted, and a self-administered questionnaire was used to collect data. Nurses from the medical and surgical inpatient wards of a tertiary teaching hospital in Malaysia were recruited in two stages using the stratified and simple random sampling methods. A total of 301 nurses participated. Descriptive analysis, an independent t test, ANOVA and hierarchical multiple regression were employed to analyse the data using SPSS software version 25. In addition, a STROBE checklist was used to report the results of this study. Nurses were found to have good knowledge, a positive attitude and good perceived practice regarding CAUTI prevention. Nurses aged above 30 and who had more than ten years of experience reported higher knowledge levels. Knowledge was found to be positively correlated with attitude and perceived practice; however, attitude explained a higher variance in perceived practice of CAUTI prevention compared with knowledge. Attitude was found to have a higher significant influence on perceived practice in this study. Educators need to emphasise the inculcation of a positive attitude among nurses rather than just knowledge for CAUTI prevention. Since this study assessed perceived practice, examining nurses' actual practice and its impact on patient outcomes is recommended in future studies.

Improve the Integrity Rate of Response and Teaching for Tube Care Administered by the Primary Caregiver

The need to use an indwelling nasogastric tube, urinary catheter, or tracheostomy tube (the so-called "three tubes") because of illness or prolonged bedrest is increasing. The functions and effectiveness of these tubes may be maintained only with correct care. Improper care, slippage, obstruction, or infection may in severe cases cause septic shock or even death. To increase the completeness of the reverse demonstration of three tubes care instructions by primary caregivers to further improve related care quality. Between February 10th and March 31st, 2019, the completeness rates of reverse demonstration of nasogastric tube, urinary catheter, and tracheostomy tube care instructions among the primary caregivers participating in this study were shown to be low, at 42.5%, 38%, and 58.3%, respectively. The plausible causes were: 1. Human: Poor communication, forgetting the care steps, having no time for learning, and fear of performing nasogastric tube rotation; 2. Instrument: Lack of graphic demonstrations in health education materials; 3. Policy: Lack of standards and auditing. The implemented intervention involved creating innovative health-education instruments, videos and flash cards about three tubes care in multiple languages, and straps for holding the urinary catheter and developing standards and an auditing system for the reverse demonstration of three tube care instructions by primary caregivers. The completeness rates for the reverse demonstration of nasogastric tube, urinary catheter, and tracheostomy tube care instructions among the primary caregivers improved to 97.3%, 96.3%, and 95%, respectively. Using the innovative health-education aids and improvements introduced in this study, the ability of primary caregivers to correctly perform the care steps should improve significantly.

Development of a Computer Application Used by Visiting Nurses, Physicians, and Patients/Caregivers to Prevent Indwelling Urinary Catheter Occlusion in the Community.

This study aimed to develop a computer application (software) for use by visiting nurses, physicians, and patients/caregivers, to support their care of long-term indwelling urinary catheters in the community. Development of this application involved: (1) confirmation of the intended purpose, users, and application construction; (2) establishment of the functional requirements for data sharing and communication among visiting nurses, physicians, and patients/caregivers; (3) design of three constituent "versions" of the application to be used by visiting nurses, physicians, and patients/caregivers, respectively; and (4) testing of the data sharing and communication functions. The application was designed to facilitate the prevention, assessment, and response to occlusion of indwelling urinary catheters during long-term use at home. This application is characterized by: (1) a unique design of three application "versions" that each reflect the specific care roles of its respective user group; (2) data sharing among the three groups according to their respective roles; and (3) the inclusion of caregivers as users. This article proposes a model that can inform the design of future applications for nursing professionals and patients and caregivers and provide a basis for future research on the development of healthcare applications supporting improvements in care.

40 Improving Urinary Catheter Documentation and Care in Geriatric Wards

Abstract Introduction NICE guidelines state that urinary catheter insertion, changes and care should be documented. Duration of catheterization is directly linked to the risk of developing a catheter-associated UTI. Furthermore, Public Health England has announced a national aim to reduce the incidence of Gram-negative bacteraemia by 50% by March 2021, and targeting catheters is one of the first steps. Local problem These issues are relevant to the elderly population at Princess Royal University Hospital, where documentation surrounding catheters was found to be inadequate. Despite there being an Electronic Patient Record (EPR) order for catheter insertion and monitoring available, this was not being used. Our primary aim was for all patients to have this order. We also hoped to reduce the weekly rate of catheter days (catheter days per 100 bed days), and improve documentation in clinical notes. Methods We focused on two medical wards and sampled all patients admitted over a period of 4 months who had a catheter at the time of data collection. We identified catheterized patients and whether they had an EPR catheter order on a daily basis. Additional parameters such as indication, insertion date, inserter, and documentation standards were extracted from EPR on a weekly basis. Patients were kept “live” and contributing to catheter day calculations until they were no longer on the ward or if the catheter was removed. Interventions We implemented changes over 2 PDSA cycles. Interventions included the addition of catheter columns to boards and education sessions for doctors and nurses (cycle 1), as well as catheter posters, alert cards, and circulation of emails with guidance to doctors and nursing staff (cycle 2). Results A total of 87 patients were analysed during the project. There was an increase in EPR orders being used, with the 100% target being reached on the final data collection point, and with data showing a significant shift above baseline. Furthermore, there was a decrease in the weekly rate of catheter days, but changes were difficult to sustain. We also saw a general improvement in documentation standards. Conclusion By improving documentation and reducing unnecessary catheterization, we hope to have reduced the overall risk of infection whilst improving patient comfort and experience. Lessons may be transferrable to other trusts.