nurse-driven urinary catheter removal protocol, health and medicine homework help
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My capstone EBP project is to develop a nurse-driven urinary catheter removal protocol within the surgical ICU. There is currently no protocol for this and thus there is no standardized orders. Every patient is treated differently depending on which Attending or Resident is giving orders. One financial aspect that must considered is the cost of more straight catheter sets. Inevitably, since the protocol will call for urinary catheters to be removed at 24 hours post-op, there may be more urinary retention that what we are used to seeing, which will have to be treated with straight caths. Most of our catheters stay in well over 48 hours at this point, which allows more time for bothersome effects of anesthetic to pass (Tsambarlis et al., 2016).
One quality aspect that must considered with this EBP protocol is whether it will actually lower CAUTI rates and decrease urinary catheter days. The research on this is mixed but all point to better outcomes overall. It will still be interesting to see and could affect the sustainability of the protocol within the Surgical ICU in particular, due to the prolonged effects of some of the anesthetic. Many of the studies show a reduction in CAUTI but mixed outcomes on reduction of catheter days (Meddings et al., 2013; Yatim et al., 2016).
One clinical aspect that must considered with this EBP protocol is the proper use of the bladder scanner. Multiple studies have shown that bladder scan results can vary widely depending on the technique used. Education must be done with all nurses and healthcare techs to ensure proper technique is being used. Improper technique could result in needless straight cath procedures and an increase in CAUTI rates, reflecting negatively on the new protocol (Meddings et al., 2015).