Surgeons use indwelling bladder catheters (IBCs) to avoid urinary retention in patients with epidural analgesic catheters. Reduction of IBC-days is associated with improved catheter-associated urinary tract infection rates (CAUTI). This study investigates real world application of a Nurse-Driven Catheter Removal Protocol (NDCRP) to reduce IBC-days in this patient population.
Patients with epidural catheters and IBC were targeted for IBC removal on post-operative day 1 (POD1). Patients were followed for application of the NDCRP, catheterization need, IBC re-anchoring, and complications.
133 patients had IBCs removed on POD1 (Protocol Group) and 50 patients did not (Non-Protocol Group). There was a reduction in IBC-days in the Protocol Group despite incomplete adherence to the NDCRP (1.55 days vs. 4.64 days; p < 0.001). Ninety-three patients (70%) were able to spontaneously void after early IBC removal. Fourteen patients (11%) were able to spontaneously void after serial in-and-out catheterization (I/O). No significant difference in re-anchoring was found between the protocol and non-protocol groups (26 vs. 4 patients; p = 0.09).
Early removal of IBCs (POD1) in patients with epidural catheters with the assistance of an NDCRP is a safe and successful strategy to reduce IBC-days in the hospital.
American journal of infection control. 2021 Sep 19 [Epub ahead of print]
Lana Dbeibo, Yar Luan Yeap, Haley Porter, Terrie Beeson, C Max Schmidt, Michael G House, Audrey Glossenger, Kristen Kelley, Thomas J Birdax, Cole Beeler
Assistant Professor of Medicine, Indiana University School of Medicine., Associate Professor of Anesthesiology, Indiana University Department of Anesthesia., Indiana University Health., Biochemical and Molecular Biology, Indiana University, School of Medicine., Indiana University School of Medicine., Specialist-Nursing Professional Development, Indiana University Health., Director of Infection Prevention, Indiana University Health., Medical Director for Quality and Patient Safety, IUH AAHC, Associate Professor, Department of Surgery, IUMC., Assistant Professor of Medicine, Indiana University School of Medicine. Electronic address: .