Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Lam CF(1), Lam KK(1), Lam HK(1), Cheung KL(2), Lam F(2), Lee YT(2), Chan MC(3), Cheung YP(1), Choi KL (1), Wong CS(1), Kwok Y(3), Tsang WY(2), Chan KW(1), Ching KC(2), Chan T(1)
Affiliation :
(1) Orthopaedics & Traumatology, Prince of Wales Hospital (2)Orthopaedics & Traumatology, Alice Ho Miu Ling Nethersole Hospital, (3)Orthopaedics & Traumatology, Haven of Hope Hospital
Introduction :
Indwelling urinary catheters are commonly utilized for postoperative monitoring in geriatric hip fracture patients under NTEC cluster. The literature highlights that shortening indwelling catheters can lower the risk of catheter-associated urinary tract infections (CAUTIs). However, there is delay in removal and lack of standard care of the urinary catheter.
Objectives :
This study aims to implement a nurse-led protocol for early urinary catheter removal and develop standardised urinary catheter care.
Methodology :
Patients with geriatric hip fracture admitted in June and July 2023 were assigned to control and intervention groups respectively. A nurse-led early removal protocol was designed based on Houdini protocol & Centre for Health Promotion (CHP) guideline. The days of using a urinary catheter, the incident rate of CAUTIs and catheter reinsertion rate were collected. Moreover, the reasons for delaying the removal of the catheter in the control group were also collected for analysing.
Result & Outcome :
The days of indwelling urinary catheter (1.3043, <0.01), urinary catheter reinsertion rate showed statistically significant in intervention group (0%, <0.01). Whereas, CAUTIs rate (control: 9.7%, intervention: 0%) was not statistically significant, potentially due to small sample size and the short length of acute hospital stays. The reason for delay in removal of urinary catheter included lack of daily review of the usage(77.4%), lack of plan on urinary catheter removal (74.2%),need of nursing reminder was associated with prolonged usage of indwelling catheter. The nurse-led urinary catheter removal protocol emphasized daily catheter usage review and adherence to standardized catheter care aligned with CHP guideline. It helps to reduce indwelling catheter duration and reinsertion rate. This study provides a valuable groundwork for further investigation of the association between indwelling catheter duration and CAUTIs. Integrating this nurse-led protocol with the existing catheter weaning protocol for patients experiencing acute postoperative urinary retention facilitates a shift towards nursing-independent catheter removal, ensuring a more efficient and streamlined approach.
