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.