scholarly journals Change in staff perspectives on indwelling urinary catheter use after implementation of an intervention bundle in seven Swiss acute care hospitals: results of a before/after survey study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028740 ◽  
Author(s):  
Andrea Niederhauser ◽  
Stephanie Züllig ◽  
Jonas Marschall ◽  
Alexander Schweiger ◽  
Gregor John ◽  
...  
Keyword(s):  
Acute Care ◽  
Response Rate ◽  
Urinary Catheter ◽  
Acute Care Hospitals ◽  
Evidence Based ◽  
Improvement Project ◽  
Staff Members ◽  
Indwelling Urinary Catheter ◽  
Current Practices

ObjectiveTo evaluate changes in staff perspectives towards indwelling urinary catheter (IUC) use after implementation of a 1-year quality improvement project.DesignRepeated cross-sectional survey at baseline (October 2016) and 12-month follow-up (October 2017).SettingSeven acute care hospitals in Switzerland.ParticipantsThe survey was targeted at all nursing and medical staff members working at the participating hospitals at the time of survey distribution. A total of 1579 staff members participated in the baseline survey (T0) (49% response rate) and 1527 participated in the follow-up survey (T1) (47% response rate).InterventionA multimodal intervention bundle, consisting of an evidence-based indication list, daily re-evaluation of ongoing catheter need and staff training, was implemented over the course of 9 months.Main outcome measuresStaff knowledge (15 items), perception of current practices and culture (scale 1–7), self-reported responsibilities (multiple-response question) and determinants of behaviour (scale 1–7) before and after implementation of the intervention bundle.ResultsThe mean number of correctly answered knowledge questions increased significantly between the two survey periods (T0: 10.4, T1: 11.0; p<0.001). Self-reported responsibilities with regard to IUC management by nurses and physicians changed only slightly over time. Perception of current practices and culture in regard to safe urinary catheter use increased significantly (T0: 5.3, T1: 5.5; p<0.001). Significant changes were also observed for determinants of behaviour (T0: 5.3, T1: 5.6; p<0.001).ConclusionWe found small but significant changes in staff perceptions after implementation of an evidence-based intervention bundle. Efforts now need to be targeted at sustaining and reinforcing these changes, so that restrictive use of IUCs becomes an integral part of the hospital culture.

Variations in indwelling urinary catheter use in four Australian acute care hospitals

2019 ◽  
Vol 28 (23-24) ◽  
pp. 4572-4581
Author(s):  
Michelle Giles ◽  
Laura Graham ◽  
Jean Ball ◽  
Wendy Watts ◽  
Jennie King ◽  
...  
Keyword(s):  
Acute Care ◽  
Urinary Catheter ◽  
Acute Care Hospitals ◽  
Indwelling Urinary Catheter

Reprocessing and Reuse of Single-Use Medical Devices: A National Survey of Canadian Acute-Care Hospitals

2008 ◽  
Vol 29 (5) ◽  
pp. 437-439 ◽  
Author(s):  
Julie Polisena ◽  
David Hailey ◽  
Kristen Moulton ◽  
Hussein Z. Noorani ◽  
Philip Jacobs ◽  
...  
Keyword(s):  
Acute Care ◽  
National Survey ◽  
Medical Devices ◽  
Response Rate ◽  
Acute Care Hospitals ◽  
Canadian Hospital ◽  
The Past ◽  
Single Use ◽  
Hospital Practices ◽  
Current Practices

A national survey investigated the current practices of reprocessing and reusing single-use medical devices in Canadian acute-care hospitals. Our response rate was 72% (413 responses), and 28% of hospitals reprocess single-use devices. The results showed that Canadian hospital practices have not changed much in the past decade.

Clean or sterile technique when inserting indwelling urinary catheter: An evaluation of nurses’ and assistant nurses’ interpretations of a guideline at an acute-care hospital in Sweden

2018 ◽  
Vol 39 (2) ◽  
pp. 92-97
Author(s):  
Aysel Kulbay ◽  
Ann Tammelin
Keyword(s):  
Urinary Bladder ◽  
Acute Care ◽  
Urinary Catheter ◽  
Acute Care Hospital ◽  
Evidence Based ◽  
Urinary Catheterization ◽  
Care Hospital ◽  
Urinary Catheters ◽  
Sterile Technique ◽  
Assistant Nurses

Insertion of indwelling urinary catheters should be performed in a way that minimizes the risk of introducing bacteria to the urinary bladder. Nurses and assistant nurses from three departments at an acute-care hospital in Sweden answered a questionnaire about their insertion of urinary catheterization. Of the 563 nurses, 92% answered the questionnaire. Among the 492 who performed catheterization, 58% ( n = 287) said that they followed the hospital guideline. Two-thirds of those following the hospital guideline said that they used clean technique and one-third sterile technique. In all, 82% considered the catheter should be kept sterile while inserted but only 16% described all the prerequisites to achieve this. Over 90% of the respondents performed catheterization less than once a week. Our conclusion is that a guideline should describe every step of catheterization in detail and that an evidence-based process for implementation of the guideline is necessary to achieve uniformity in performance.

scholarly journals A lack of allocated research time challenges the extent of the implementation of evidence-based practice - A three-year retrospective follow-up cohort study of Master of Science in Nursing graduates

2020 ◽  
Vol 10 (8) ◽  
pp. 19
Author(s):  
Connie Berthelsen
Keyword(s):  
Response Rate ◽  
Evidence Based Practice ◽  
Research Utilization ◽  
Evidence Based ◽  
Nursing Graduates ◽  
Nursing Management ◽  
Master Of Science ◽  
Belief Scale ◽  
Ebp Implementation

Objective: To describe and compare the development of Master of Science in Nursing graduates’ research utilization and improvement of knowledge, one to three years after graduation, and to describe their beliefs, abilities and implementation regarding evidence-based practice in the workplace.Methods: Sixty-five Master of Science in Nursing (MSN) graduates, associated with an academic cohort, were invited to participate in a three-year retrospective follow-up study. Forty-five MSN graduates replied, providing a response rate of 69.23%. A questionnaire of four areas, consisting of the customary cohort questionnaire combined with the EBP Belief scale and the EBP Implementation scale, was sent to the participants using SurveyMonkey®.Results: An overall increased development in MSN graduates’ research utilization and knowledge improvement in all parameters was found from one to three years after graduation, along with greater knowledge of, and a stronger belief in the value of, evidence-based practice. However, a strong decrease in allocated time for research was found, leading to a very limited implementation of evidence-based practice by the MSN graduates.Conclusions: The study ends with a question about whether time is still an issue – even for academic nurses, who are educated and employed to implement evidence-based practice. If the barriers to nursing research are not taken seriously by nursing management then the extent of implementation of evidence-based practice and the improvement of quality in patient care and trajectories will continue to be very limited.

scholarly journals Perceptions of the Barriers, Facilitators, Outcomes, and Helpfulness of Strategies to Implement Screening, Brief Intervention, and Referral to Treatment in Acute Care

2021 ◽  
Author(s):  
Alyson Keen ◽  
Kelli M Thoele ◽  
Ukamaka Oruche ◽  
Robin Newhouse
Keyword(s):  
Acute Care ◽  
Brief Intervention ◽  
Qualitative Data ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Clinical Intervention ◽  
Structured Interview ◽  
Evidence Based ◽  
Positive Health

Abstract Background: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based clinical intervention used to reduce alcohol and illicit drug use. SBIRT use has resulted in positive health and social outcomes; however, SBIRT implementation remains low. Research on implementing evidence-based interventions, such as SBIRT, lacks information about challenges and successes related to implementation. The Expert Recommendations for Implementing Change (ERIC) provides a framework to guide comprehension, clarity, and relevance of strategies available for implementation research. This framework was applied to qualitative feedback gathered from site coordinators (SCs) leading SBIRT implementation. The purpose of this study was to describe the SCs’ experiences pertaining to SBIRT implementation across a health system. Methods: Within the context of a larger parent study, a semi-structured interview guide was used to capture 14 SCs’ perceptions of the barriers, facilitators, and outcomes pertaining to SBIRT implementation. This qualitative data was analyzed using standard content analytic procedures. A follow-up survey was developed based on 14 ERIC strategies identified from qualitative data and was administered electronically to determine the SC’s perceptions of the most helpful implementation strategies on a scale of 1 (least helpful) to 5 (most helpful). Results: All 14 invited SCs participated in the SBIRT implementation interview, and 11 of 14 (79%) responded to the follow-up survey. Within the categories of barriers, facilitators, and outcomes, 25 subthemes emerged. The most helpful ERIC implementation strategies were purposely reexamining the implementation (M=4.38; n=8), providing ongoing consultation (M=4.13; n=8), auditing and providing feedback (M=4.1; n=10), developing education materials (M=4.1; n=10), identifying and preparing champions (M=4; n=7), and tailoring strategies (M=4; n=7). Conclusion: SCs who led implementation efforts within a large healthcare system identified several barriers and facilitators to the implementation of SBIRT. Additionally, they identified clinician-related outcomes associated with SBIRT implementation into practice as well as strategies that were helpful in the implementation process. This information can inform the implementation of SBIRT and other interventions in acute care settings.

scholarly journals 1153. National Trend of Urinary Catheter Device Utilization by Hospital Type, National Healthcare Safety Network (2015–2019)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S411-S412
Author(s):  
Minn M Soe
Keyword(s):  
Acute Care ◽  
Negative Binomial ◽  
Urinary Catheter ◽  
Inpatient Rehabilitation ◽  
Acute Care Hospitals ◽  
Equation Modeling ◽  
Quality Reporting ◽  
Factors Associated ◽  
National Healthcare ◽  
National Healthcare Safety Network

Abstract Background Reducing unnecessary urinary catheter use and optimizing insertion techniques and catheter maintenance and care practices are the most important urinary tract infection (CAUTI) prevention strategies. To monitor device use (DU) as quality improvement activity, the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) developed the risk adjusted, standardized urinary catheter device utilization ratio in 2015. This study aims to assess national trends of DU from the baseline year 2015 through 2019. Methods For our trend analysis, we analyzed DU data (catheter days per 100 inpatient-days) that acute care hospitals (ACHs), long-term acute care hospitals (LTACHs), inpatient rehabilitation facilities (IRFs), and critical access hospitals (CAHs) reported to NHSN from 2015Q1 through 2019Q1. The ward and intensive care unit patient care locations included in our analysis are those that ACHs, LTACHs, IRFs and CAHs are required to report to CMS to comply with CMS Inpatient Quality Reporting program requirements. We regressed DU by quarterly period using generalized estimating equation modeling with the negative-binomial distribution, after adjusting for factors associated with corresponding SUR models of 2015 baseline and accounting for autocorrelation of error terms within a location. For graphic display, we also computed quarterly DU using marginal predictive models. Results The DU decreased over time (P ≤ 0.05, average percent change per quarter (%change): −0.54 [95% CI: −0.54, −0.53]) among ACHs (Table 1, Figure 1), and −0.54 [95% CI: −0.58, −0.49] among LTACHs (Table 1, Figure 2). Among IRFs, quarterly DU in 2015Q2–2016Q3 were similar relative to 2015Q1, but decreased from 2016Q4 onward (P ≤ 0.05, % change: −0.51 [95% CI: −0.61, −0.40]) (Table 1, Figure 3). Among CAHs, quarterly DU in 2015Q2–2016Q4 were similar relative to 2015Q1, but decreased from 2017Q1 onward (P ≤ 0.05, % change: −0.22 [95% CI: −0.39, −0.04]) (Table 1, Figure 4). Conclusion There was a statistically significant decrease in National DU of urinary catheter during 2015–2019 across NHSN, although the magnitude of change per quarter was not large. Further research is needed to explore causal factors associated with such reduction. Disclosures All authors: No reported disclosures.

scholarly journals Urinary Catheter Indications in the United States: Results from a National Survey of Acute Care Hospitals

2014 ◽  
Vol 35 (S3) ◽  
pp. S96-S98 ◽  
Author(s):  
M. Todd Greene ◽  
Hiroko Kiyoshi-Teo ◽  
Heidi Reichert ◽  
Sarah Krein ◽  
Sanjay Saint
Keyword(s):  
United States ◽  
Urinary Incontinence ◽  
Acute Care ◽  
National Survey ◽  
Urinary Catheter ◽  
Outlet Obstruction ◽  
Acute Care Hospitals ◽  
The United States ◽  
Urinary Catheters ◽  
Appropriate Use

In a survey of acute care hospitals across the United States, we found that many hospitals use indwelling urinary catheters for reasons that are not medically necessary (eg, urinary incontinence without outlet obstruction and patient/family requests). Our findings highlight an opportunity to reduce unnecessary catheter use through promoting awareness of appropriate use.

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