Implementation of an EBP Protocol to Reduce Use of Indwelling Urinary Catheters in the Long-Term Care Environment

2.50
Hdl Handle:
http://hdl.handle.net/10755/304220
Category:
Full-text
Type:
Presentation
Title:
Implementation of an EBP Protocol to Reduce Use of Indwelling Urinary Catheters in the Long-Term Care Environment
Author(s):
Gaspar, Phyllis M.; Gokula, Murthy
Lead Author STTI Affiliation:
Non-member
Author Details:
Phyllis M. Gaspar, PhD, RN, phyllis.gaspar@utoledo.edu; Murthy Gokula, MD, CMD;
Abstract:

Session presented on: Tuesday, July 23, 2013

Purpose: 'Use of indwelling urinary catheters (IUC) has been documented between 5-15% in long-term care (LTC) even though the Centers for Medicare and Medicaid Services (CMS), requires a valid medical justification for use.' A major complication of IUCs is infection, which is a primary cause of hospitalization of patients from LTC facilities.' UTIs also contribute to the problems of incontinence, falls and delirium. Purpose of this project was to implement the evidence based FIRM (Foley Insertion, Removal, and Maintenance) Protocol aimed to increase appropriate use of IUCs in LTC thus reducing related infections and other complications.' The protocol was a revision of an acute care protocol developed, implemented and evaluated by the authors.' Larrabee's model of evidence-based practice change guided the implementation of the study along with Model of Technology, Nursing and Patient Safety.'

Methods: The FIRM Protocol incorporated an electronic order sheet that was complimented with a web-based education program for health care providers regarding use and care of IUC, and prevention of CAUTIs.' The protocol was implemented at 14 LTC settings with 17 comparison sites.

Results: Knowledge scores of the staff of the intervention sites increased significantly following the education program from a mean of 65.5% to 77.6% compared to no change for the comparison site staff (mean =65.5%).''Review of EHRs over 3 months following implementation revealed 81 documented IUCs (13 at intervention sites; 68 at comparison sites).' 100% of the IUCs at intervention sites had an order for use compared to only 70.6% at comparison sites.' Other outcomes including rate of use and occurrence of CAUTIs will be reported.

Conclusion: Implementation of the FIRM Protocol was effective in decreasing inappropriate use of IUC in LTC environments.' Recommendations for revisions in the protocol to promote utility and efficacy at the current sites as well as other LTC settings will be presented.

Keywords:
long term care; urinary catheters; protocol
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013 ; 22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleImplementation of an EBP Protocol to Reduce Use of Indwelling Urinary Catheters in the Long-Term Care Environmenten
dc.contributor.authorGaspar, Phyllis M.en
dc.contributor.authorGokula, Murthyen
dc.contributor.departmentNon-memberen
dc.author.detailsPhyllis M. Gaspar, PhD, RN, phyllis.gaspar@utoledo.edu; Murthy Gokula, MD, CMD;en
dc.identifier.urihttp://hdl.handle.net/10755/304220-
dc.description.abstract<p>Session presented on: Tuesday, July 23, 2013</p><b>Purpose: </b>'Use of indwelling urinary catheters (IUC) has been documented between 5-15% in long-term care (LTC) even though the Centers for Medicare and Medicaid Services (CMS), requires a valid medical justification for use.' A major complication of IUCs is infection, which is a primary cause of hospitalization of patients from LTC facilities.' UTIs also contribute to the problems of incontinence, falls and delirium. Purpose of this project was to implement the evidence based FIRM (Foley Insertion, Removal, and Maintenance) Protocol aimed to increase appropriate use of IUCs in LTC thus reducing related infections and other complications.' The protocol was a revision of an acute care protocol developed, implemented and evaluated by the authors.' Larrabee's model of evidence-based practice change guided the implementation of the study along with Model of Technology, Nursing and Patient Safety.' <p><b>Methods: </b>The FIRM Protocol incorporated an electronic order sheet that was complimented with a web-based education program for health care providers regarding use and care of IUC, and prevention of CAUTIs.' The protocol was implemented at 14 LTC settings with 17 comparison sites. <p><b>Results: </b>Knowledge scores of the staff of the intervention sites increased significantly following the education program from a mean of 65.5% to 77.6% compared to no change for the comparison site staff (mean =65.5%).''Review of EHRs over 3 months following implementation revealed 81 documented IUCs (13 at intervention sites; 68 at comparison sites).' 100% of the IUCs at intervention sites had an order for use compared to only 70.6% at comparison sites.' Other outcomes including rate of use and occurrence of CAUTIs will be reported. <p><b>Conclusion: </b>Implementation of the FIRM Protocol was effective in decreasing inappropriate use of IUC in LTC environments.' Recommendations for revisions in the protocol to promote utility and efficacy at the current sites as well as other LTC settings will be presented.en
dc.subjectlong term careen
dc.subjecturinary cathetersen
dc.subjectprotocolen
dc.date.available2013-10-22T20:31:28Z-
dc.date.issued2013-10-22-
dc.date.issued2013-10-22en
dc.date.accessioned2013-10-22T20:31:28Z-
dc.conference.date2013en
dc.conference.name24th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationPrague, Czech Republicen
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en
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