UTI's continue to be problematic even with current standards of catheter care. To decrease UTI's in patients with urinary catheters and to decrease use of indwelling urinary catheters throughout a large rural(6) hospital system, an innovative poster and video approach was used for inservicing Nursing Staff. Between 1-1-00 thru 12-31-00 at the main unit, UTI's were #3 n=499 or 1.8% of all discharges. The most frequent complication at discharge was CHF which was 2.0%. Patients with UTI's as a secondary diagnosis had an average lenth of stay of 9.1 days, vs those without a urinary catheter of 4.7 days. Data was gathered on urinary catheter usage. An outcome profile and comparisons were made thru mortality, morbidity, LOS and costs. Before and after data were compared with regards to implementation of the system wide education project. An educational poster with CEU's was developed concerning decreasing UTI's and spend a minimum of (1) week on each nursing unit along with an internally prepared video tape made mandatory by a CNS and medical director of urology. Because of this project, policy and procedures were evaluted thoughout the system. It became policy in OR not to routinely use urinary catheters for short procedures of 2 hours or less. CNS for Med/Surg made rounds during nursing report and discharge planning rounds reinterating early discontinuation to nursing and medical staff on a large general surgical floor. This triggered nursing staff to approach the physician(s) on a daily basis if not per shift to discontinue the catheter, especially on non-urological patients. Prompts were built into our nursing computer charting system and fliers were placed in all the physician mail boxes informing them of this project. Bladder scanner competencies were implemented for nursing staff.
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