Evaluation of a Nurse-Driven Protocol to Remove Urinary Catheters: Nurses' Perceptions

Headnote

© 2015 Society of Urologic Nurses and Associates

Olson-Sitki, K., Kirkbride, G., & Forbes, G. (2015). Evaluation of a nurse-driven protocol to remove urinary catheters: Nurses' perceptions. Urologic Nursing, 35(2), 94-99. doi:10.7257/1053-816X.2015.35.2.94

This article describes nurses' perceptions of the effect of a nurse-driven protocol in a Magnet®-designated hospital. Post-protocol implementation data indicate improved job ease and positive patient feedback following protocol implementation. Younger or less-experienced nurses were likely to use the protocol.

Key Words: Nurse-driven protocol, indwelling urinary catheter, nurses' perceptions, catheter associated urinary tract infections.

Research Summary

Introduction

Nurse-driven catheter-removal protocols have shown success in decreasing urinary catheter utilization rates and catheter-associated infections. The effect of protocol implementation on nurses' work environment and job is of interest.

Purpose

To evaluate nurses' perceptions of a nurse-driven urinary catheter-removal protocol at a 500 bed Magnet®-designated teaching hospital.

Methods

This descriptive, exempted study used a self-developed survey to elicit nurses' perceptions of the effect of an indwelling urinary catheter removal protocol on job ease, empowerment, job satisfaction, patient feedback, and physician feedback. Ninety-one (91) RNs completed the survey, and of those, 48 used the removal protocol.

Results

Data were analyzed using Chi-square statistics. Nurses' perceptions of both job ease (c2 = 13.33, p < 0.0001) and patient feedback (c2 = 10.31, p = 0.001) were significantly higher with protocol use. Younger or less-experienced RNs were more likely to use the protocol. No significance was found in empowerment, job satisfaction, or nurses' perceptions for physician feedback in those who used the protocol.

Conclusions

Implementation of a nurse-driven urinary catheterremoval protocol significantly improved nurses' perceptions of job ease and patient feedback.

Level of Evidence - VI

(Polit & Beck, 2012)

Urinary tract infection (UTI) is one of the most common hospital-associated infections, and urinary catheters are associated with 70% to 80% of those infections (Lo et al., 2014). Research data indicate that the risk of infection increases about 5% each day a catheter remains in place; thus, it is imperative that catheters be removed as soon as possible (Gould et al., 2014). The Joint Commission (2015) recognizes catheter-associated urinary tract infection (CAUTI) prevention as one of the National Patient Safety Goals for hospitals. Nursing care plays a vital role in CAUTI prevention; thus, the American Nurses Association (ANA)...