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When only physicians are trained to insert Coudé catheters, there is an increased burden to both the patient and the providers. Training nurses for placement of Coudé catheters can improve care and allow for better use of health care resources.
Key Words: Coudé catheter, quality improvement project.
Summary
Problem
The practice at our institution, after a failed catheterization attempt by the nurse, was to request a consultation for catheter placement from the urologist. When after hours, this required the attending urologist to come to the hospital. This process was burdensome and costly to both providers and patients.
Objective
The goal of the project was to shift the primary responsibility of Coudé catheter placement during the off-shift from the physicians to a group of specially trained nurses.
Methods
An educational program intended to improve nurses' knowledge, comfort, and psychomotor skills related to the use of Coudé catheters was developed based on Bloom's Taxonomy of Educational Objectives, and implemented and evaluated using pre- and post-test data.
Results
Program participants felt better prepared to perform Coudé catheter insertion.
Conclusions
Using appropriate methods of instruction, we were able to create a team of confident and competent nurses who are now knowledgeable about and comfortable with Coudé catheter placement.
Level of Evidence - Level VI
(Polit & Beck, 2014)
Approximately 24 million urinary catheters are purchased annually by hospitals in the United States annually (Kashefi, Messer, Barden, Sexton, & Parsons, 2008). With nearly 25% of hospitalized patients receiving an indwelling urinary catheter (to be referred to as catheter) (Saint & Lipsky, 1999), it is clear that urethral catheterization is a common procedure. Due to the shorter length of the female urethra, women are typically easier to catheterize. In men, the combination of a longer urethra, the prostate gland, and associated pathologies affecting these two structures increases the likelihood of abnormalities that make the process of catheterization more challenging.
Although the majority of catheter placements are straightforward, there are instances in which placement can be difficult, leading to complications. These can include urethral injuries; catheter-associated urinary tract infections; hematuria; false passages; urethral, rectal, or bladder perforations; meatal stenosis; Fournier's gangrene; and urethralrectal fistulas (Canales, Weiland, Reardon, & Monga, 2009; Igawa, Wyndaele, & Nishizawa, 2008; Radhakrishnan, Marsh, Sheikh, Johnson, & Greene,...