Date of Graduation

Spring 5-17-2024

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Alicia Kletter, DNP, APRN, FNP-BC, PMHNP-BC

Abstract

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit director. One-on-one conversations explaining the use of the posters were conducted with bedside nurses. Stickers with a cartoon IUC and the text “Why am I here?” were distributed as a light-hearted conversation starter to promote IUC discussion. Measures Interdisciplinary rounds were observed before and after the intervention to measure the proportion of rounds in which IUC indication or removal was discussed by members of the care team. The catheter utilization rate was compared between the pre- and post-intervention periods. Results The frequency of interdisciplinary rounds discussing IUC indication or removal increased from 23% to 30%. Catheter days per patient day decreased by 20% from a rate of 0.61 in April 2023 to 0.50 from April 1-21, 2024. Conclusions Early findings suggest that promoting interdisciplinary communication with visual reminders increases communication and decreases IUC utilization. More evaluation is needed to determine sustainability and impact over time.

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