Inspiring Change: Reducing urinary catheter days
Vikrant Uberoi MD
Nahomy Calixte MD
Vanessa R. Coronel RN
Debra J. Furlong RN
Ralph P. Orlando MD
Lori B. Lerner MD

January 2013 
Volume 43  Number 1
Pages 16 - 20
  PDF Version Available!

GIVEN THE SIGNIFICANT morbidity, cost, and decreased reimbursement for healthcare-associated infections, the importance of preventing catheter-associated urinary tract infections (CAUTIs) has never been higher.1 Over 80% of hospital-acquired urinary tract infections (UTIs) are associated with catheters, spurring many hospitals to develop initiatives to aggressively reduce catheter days.2In 2008 at Boston Veterans Hospital, the CAUTI rate in surgical patients (2.6%) was above the national average (1.9%). A full retrospective review revealed that after hip and knee replacement surgery, 8% of patients developed symptomatic acute urinary retention (AUR) after catheter removal and required intervention. Recognizing that postoperative urinary retention poses a risk for CAUTI, an effort was made to reduce recatheterization rates.1 This article describes our project and results.Surgical patients who develop AUR are at particularly high risk for repeated catheterization, prolonged catheter days, and CAUTI. By one estimate, the incidence of postoperative urinary retention is 5%; however, rates vary greatly.3 Orthopedic patients, for example, are at particular risk due to postoperative immobility, use of opioids, and advanced age. A recent study found a 38% incidence of urinary retention.2Patients who develop AUR postoperatively require intervention with either an indwelling catheter or intermittent catheterization. The rate of bacteriuria associated with short-term catheterization is 5% to 10% for each day of catheterization.4 As catheter duration increases, so does the risk of hospital-acquired UTIs.The section of urology at VA Boston Healthcare, in conjunction with nursing staff, designed a bladder management protocol (BMP) for orthopedic patients undergoing primary total hip or knee replacements. We set out to answer four questions: * Does the identification of preoperative urinary retention in patients undergoing total joint replacement surgery decrease the incidence of postoperative

Purchase Now !

To purchase this item, follow the instructions below. If you’re not already logged in, be sure to enter your login information below to ensure that your item is saved to your File Drawer after you purchase it.

Not a member? Join now for Free!

1) If you're not already logged in, enter your information below to save this item in your File Drawer for future viewing.

User name:


Forgot your user name or password?
2)  If you have a coupon or promotional code, enter it
here.(If not, just click Continue.

Digital Coupon: (optional)

3)  Click Continue to go to the next screen, where
you'll enter your payment details.

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles Recommended Nursing Articles Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events