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Urinary Catheter Process Measures Improve in MI

Cheryl Clark, for HealthLeaders Media, February 13, 2012

Longstanding practice patterns are hard to change, but in a project led by Michigan hospital researchers, 71 organizations reduced their overall percentage of inappropriate urinary catheter use from 18.1% to 13.8% over two years.

The percentage of catheters meeting appropriateness criteria increased from 44.3% to 57.6%, measured in patient catheter days.

"Our results indicate that hospitals can improve appropriate urinary catheter use and that such efforts can be successfully implemented on a broad scale," wrote Sanjay Saint, MD, and co-authors in an article published Monday in the Archives of Internal Medicine.

In a set measurement period of 20-weeks, for example, the percentage of inappropriate catheter use was halved for patients whose only indication was non-obstructive renal insufficiency, and dropped by one-third for patients who were confused or incontinent, which are not justified reasons for a urinary catheter.

The project was sponsored by the Michigan Health and Hospital Association (MHA) Keystone Center, which had seen a 45% reduction at just one hospital after an aggressive nurse-led effort to remove unnecessary catheters in 2007.

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2 comments on "Urinary Catheter Process Measures Improve in MI"


rachel (3/4/2012 at 7:10 AM)
I care for a spinal cord injured male patient, and almost any contact with his penis causes a spontaneous erection, even routine perineal washing or adjusting the sheets. This causes difficulty [INVALID]ing a catheter, which causes discomfort for him, and concerns me. It took some time for me to be comfortable dealing with a a male with reflexive erections in general, but now I am concerned because I feel a lot more resistance [INVALID]ing a catheter into him than with most male patients, particularly during the last few inches – I'm assuming that this involves his prostate and/or urogenital diaphragm. Do you have any suggestions or tips? As he doesn't have normal sensation below his shoulders (C4-5 injury), I have considered many things, including manually inducing an orgasm to allow his penis to become flaccid, but I'm not sure that would be appropriate, or even helpful. I've tried waiting up to 15-20 minutes after [INVALID]ing the lidocaine gel, but the erections are quite persistent – Any ideas, suggestions, or tips would be greatly appreciated! Thank you, rachel from <a href="http://www.brightmedical.com/adult-diapers">ADULT DIAPERS</a>

ADULT DIAPERS (2/19/2012 at 8:48 AM)
Urinary catheters were said to be appropriate for urinary tract obstruction, neurogenic bladder, urologic study or surgery on contiguous structures, sacral pressure ulcer (stage III or IV) with incontinence, and end of life care.