Purpose/Objectives:
The objectives of this study were to prevent and remove Foley catheters when they are "unnecessary," reduce the incidence of urinary tract infections (UTIs) related to Foley catheters, and promote autonomous nursing practice.
Significance:
Approximately 600,000 patients per year develop hospital-acquired UTIs and account for 40% of hospital-acquired infections. On average, 40% to 50% of patients who receive a Foley catheter do not have a valid indication for placement.
Design/Background/Rationale:
Urinary tract infections and other complications related to insertion of a Foley catheter are preventable for the hospitalized patient. Nursing has the opportunity to improve patient outcomes when empowered to practice autonomously. Critical thinking and clinical judgment enable nursing to remove or prevent unnecessary Foley catheters. A continued effort to make practitioners aware and have an understanding of nursing policy, procedure, and protocols ensures a culture of safety.
Methods/Description:
It takes a multidisciplinary approach to create a Foley Free Zone. Collaborative efforts by a clinical nurse specialist (CNS), infection control practitioner, and a physician lead guided a process improvement project that would demonstrate the necessity to a have a structured process to implement interventions that promote best practices for patients. The process of preparing, educating, and implementing is at the cornerstone of every CNS-led initiative and serves as a foundational structure. Each unit of a large, midwestern hospital was provided with multiple 1-hour informational sessions introducing the Foley Free Zone initiative. The CNS who began the original work either led or attended most of the sessions held on the nursing units. The CNS presented the same information to various medical forums with the physician lead and worked very closely with the infection control practitioner to create presentations for other institutions.
Findings/Outcomes:
A significant decrease in the number of Foley catheters on a medical unit was found. This effort achieved a decrease in point prevalence from 10.4 Foley catheters to 3.9 Foley catheters per day.
Conclusions:
Providing safe and quality care can reduce the incidence of urinary tract infection when Foley catheters are prevented or removed when unnecessary.
Implications for Practice:
This study promotes collaborative efforts between nursing and medicine and creates a culture of safety for patients.
Section Description
The 2009 NACNS National Conference will be held in St Louis, Missouri, on March 5 to 7. More than 350 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are registered. This year's theme, "Clinical Nurse Specialists: Vision, Value, Voice," demonstrates the essential leadership skills of the CNS as well as the CNS role in implementing evidence-based practice.
Seventy abstracts were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session. The abstracts addressed CNS practice in 3 practice domains (spheres of influence), emphasizing patient safety and quality care outcomes, leadership, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into 3 spheres of influence-patients, nursing practice, organization/system-including the development of clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, CNS practice in end-of-life care decisions, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNSs' contribution to the well-being of individuals, families, communities, as well as to the advancement of the nursing profession.
The conference abstracts were published here to facilitate sharing this emerging new knowledge with those who were unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics. Watch out for next year's call for abstracts and consider submitting for presentation at NACNS' next annual conference in Portland, Oregon, on March 4 to 6, 2010.