De-implementation of Urinary Catheters in Neurosurgical Patients During the Operation and on the Ward: a Mixed-methods Study Protocol

BackgroundIndwelling urinary catheters (IDUCS) are frequently routinely inserted during transsphenoidal pituitary gland tumour surgery or spinal fusion surgery despite literature stating that there are no indications for using IDUCS during or after these surgeries. The aim of the study is to reduce the number of inappropriately inserted IDUCs in during or after transsphenoidal pituitary gland tumour surgery and spinal fusion surgery with an operation time of <4 hours. Methods A pragmatic, before-and-after mixed-methods observational study including medical chart analysis, satisfaction surveys with patients and healthcare professionals and multidisciplinary group interviews to assess the effectiveness of and experiences with various non-invasive de-implementation strategies aimed to decrease the number of inappropriate IDUCS inserted during and after transsphenoidal pituitary gland tumour surgery and spinal fusion surgery in a multicentre context. Discussion This paper presents the study protocol of a multi-centred before and after trial that aims to reduce inappropriate IDUC use after transsphenoidal pituitary gland tumour surgery and spinal fusion surgery, and thereby reducing UTIs, shortening hospital stay and increasing patient comfort. The results can be used to de-implement IDUCs after a broad range of surgeries on several wards.Trial registration The study has been submitted to the Dutch Trial Register (NTR).