Accidental Late Adaptor: Onboarding Surgical Services to a Developed Catheter-Associated Urinary Tract Infection Prevention Protocol

The lack of a unit-based educator for a period of time in surgical services fuelled the development of a nursing staff knowledge deficit regarding a hospital-wide evidence-based CAUTI prevention protocol. The operating room nurse educator identified the need for a change in nursing workflow due to the introduction of an improved indwelling urinary catheter kit. Though staff had completed an online learning module, they were unsure of how to implement the care measures necessary to prevent CAUTI. In addition to assessing urinary catheter maintenance practice knowledge deficits among staff, the operating room educator encountered staff resistance to practice change. During evaluation of urinary catheter care processes, the operating room nurse educator and management team discovered that the pre-assembled surgical packs were not sufficiently stocked to meet the hospital-wide CAUTI prevention protocol. While evaluating the pre-assembled kit contents, discussion was initiated as to the necessity of including indwelling urinary catheters for each procedure using pre-assembled kits. This presentation will address common barriers to improving urinary catheter care in the operating room, the process for urinary catheter equipment evaluation, and methods to decrease urinary catheter use in selected populations. Ultimately, this presentation will highlight operating room culture change, with a heightened awareness that care in the operating room directly impacts patient outcomes throughout the hospital stay.

References:

Blanchard, J. (2011). Use of indwelling urinary catheters for perioperative patients. AORN Journal, 93(1), 165-171.

Meddings, J., Rogers, M.A., Krein, S., Fakih, M., Olmsted, S. (2013). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Quality and Safety, 0, 1-13.