Setting-Specific Interventions

HOSPITAL

• A method to reduce use of catheters for staff convenience was presented by McLaughlin & Scuito (1996).
• UI is often overlooked as a cause of infection in elderly patients, especially in hospitalized patients.
• Catheters are also associated with an increase in morbidity.
• Urinary tract infections in the elderly frequently do not have typical symptoms, such as fever or increased white blood cell count.
• A survey was done which revealed that 90% of catheters were for the convenience of the staff.
  • A program of inservice and education was set up using the Center for Disease Control and Prevention's (CDC) guidelines.
  • The myth that UI is a normal part of aging was dispelled.
  • Causes of UI were taught to the staff. Pocket cards were distributed to assist in assessment of need for catheters.
  • A catheter patrol was formed by a nursing team.
  • A flow sheet was placed in the chart to facilitate monitoring use of foley catheters and outcomes.
  • Six months after implementation of the program the use of convenience catheters dropped to zero.
  • UTIs were not eliminated in the use of catheters that meet the five criteria for use based on CDC guidelines.
• The five criteria for use of catheters, based on CDC guidelines are:
  1. To relieve urinary tract obstruction
  2. To permit urinary drainage in patients with neurogenic bladder dysfunction and urinary retention.
  3. To obtain accurate intake and output in critically ill patients.
  4. To aid in urological surgery or other surgery in adjacent areas.
  5. Special needs that outweigh the risk.

Instant Feedback:

The Centers for Disease Control (CDC) recommends the use of foley catheters for UI patients to prevent skin breakdown.

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