Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method.
healthcare quality improvement
nosocomial infections
patient safety
Journal
BMJ quality & safety
ISSN: 2044-5423
Titre abrégé: BMJ Qual Saf
Pays: England
ID NLM: 101546984
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
27
02
2018
revised:
12
06
2018
accepted:
30
06
2018
pubmed:
14
8
2018
medline:
18
1
2020
entrez:
14
8
2018
Statut:
ppublish
Résumé
Indwelling urinary catheters are commonly used for patients undergoing general and orthopaedic surgery. Despite infectious and non-infectious harms of urinary catheters, there is limited guidance available to surgery teams regarding appropriate perioperative catheter use. Using the RAND Corporation/University of California Los Angeles (RAND/UCLA) Appropriateness Method, we assessed the appropriateness of indwelling urinary catheter placement and different timings of catheter removal for routine general and orthopaedic surgery procedures. Two multidisciplinary panels consisting of 13 and 11 members (physicians and nurses) for general and orthopaedic surgery, respectively, reviewed the available literature regarding the impact of different perioperative catheter use strategies. Using a standardised, multiround rating process, the panels independently rated clinical scenarios (91 general surgery, 36 orthopaedic surgery) for urinary catheter placement and postoperative duration of use as appropriate (ie, benefits outweigh risks), inappropriate or of uncertain appropriateness. Appropriateness of catheter use varied by procedure, accounting for procedure-specific risks as well as expected procedure time and intravenous fluids. Procedural appropriateness ratings for catheters were summarised for clinical use into three groups: (1) can perform surgery without catheter; (2) use intraoperatively only, ideally remove before leaving the operating room; and (3) use intraoperatively and keep catheter until postoperative days 1-4. Specific recommendations were provided by procedure, with postoperative day 1 being appropriate for catheter removal for first voiding trial for many procedures. We defined the appropriateness of indwelling urinary catheter use during and after common general and orthopaedic surgical procedures. These ratings may help reduce catheter-associated complications for patients undergoing these procedures.
Sections du résumé
BACKGROUND
Indwelling urinary catheters are commonly used for patients undergoing general and orthopaedic surgery. Despite infectious and non-infectious harms of urinary catheters, there is limited guidance available to surgery teams regarding appropriate perioperative catheter use.
OBJECTIVE
Using the RAND Corporation/University of California Los Angeles (RAND/UCLA) Appropriateness Method, we assessed the appropriateness of indwelling urinary catheter placement and different timings of catheter removal for routine general and orthopaedic surgery procedures.
METHODS
Two multidisciplinary panels consisting of 13 and 11 members (physicians and nurses) for general and orthopaedic surgery, respectively, reviewed the available literature regarding the impact of different perioperative catheter use strategies. Using a standardised, multiround rating process, the panels independently rated clinical scenarios (91 general surgery, 36 orthopaedic surgery) for urinary catheter placement and postoperative duration of use as appropriate (ie, benefits outweigh risks), inappropriate or of uncertain appropriateness.
RESULTS
Appropriateness of catheter use varied by procedure, accounting for procedure-specific risks as well as expected procedure time and intravenous fluids. Procedural appropriateness ratings for catheters were summarised for clinical use into three groups: (1) can perform surgery without catheter; (2) use intraoperatively only, ideally remove before leaving the operating room; and (3) use intraoperatively and keep catheter until postoperative days 1-4. Specific recommendations were provided by procedure, with postoperative day 1 being appropriate for catheter removal for first voiding trial for many procedures.
CONCLUSION
We defined the appropriateness of indwelling urinary catheter use during and after common general and orthopaedic surgical procedures. These ratings may help reduce catheter-associated complications for patients undergoing these procedures.
Identifiants
pubmed: 30100564
pii: bmjqs-2018-008025
doi: 10.1136/bmjqs-2018-008025
pmc: PMC6365917
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Pagination
56-66Subventions
Organisme : AHRQ HHS
ID : K08 HS019767
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: JM has reported receiving honoraria for lectures and teaching related to prevention and value-based purchasing policies involving catheter-associated urinary tract infection and hospital-acquired pressure ulcers. SS has reported receiving honoraria for lectures and teaching related to prevention of catheter-associated urinary tract infection, and is on the medical advisory boards of Doximity and Jvion.
Références
Ned Tijdschr Geneeskd. 1992 Apr 25;136(17):827-31
pubmed: 1522926
J Bone Joint Surg Am. 2013 Aug 21;95(16):1498-503
pubmed: 23965700
Gerontol Geriatr Med. 2017 May 02;3:2333721417706299
pubmed: 28516129
Surg Endosc. 2015 Nov;29(11):3246-50
pubmed: 25612548
JSLS. 2014 Oct-Dec;18(4):
pubmed: 25489207
Minerva Anestesiol. 2011 Nov;77(11):1050-7
pubmed: 21597444
Am J Surg. 1984 Sep;148(3):313-6
pubmed: 6383096
Dis Colon Rectum. 2011 Jan;54(1):21-8
pubmed: 21160309
Int J Colorectal Dis. 2014 Jan;29(1):99-104
pubmed: 23982426
Surgery. 2010 Feb;147(2):219-26
pubmed: 19892383
Arch Surg. 2008 Jun;143(6):551-7
pubmed: 18559747
J Surg Res. 2009 Oct;156(2):274-7
pubmed: 19665732
BMJ Qual Saf. 2019 Jan;28(1):32-38
pubmed: 29844230
J Arthroplasty. 2001 Oct;16(7):850-5
pubmed: 11607900
J Laparoendosc Surg. 1992 Oct;2(5):215-7
pubmed: 1421538
Am J Surg. 2001 Sep;182(3):226-9
pubmed: 11587682
Eur J Anaesthesiol. 1999 Aug;16(8):503-6
pubmed: 10500936
Infect Control Hosp Epidemiol. 2008 Feb;29(2):116-24
pubmed: 18179366
Reg Anesth Pain Med. 2000 Sep-Oct;25(5):498-501
pubmed: 11009235
Surg Endosc. 2013 Dec;27(12):4711-20
pubmed: 23955727
BMC Musculoskelet Disord. 2008 Apr 28;9:59
pubmed: 18442380
Dis Colon Rectum. 2014 Jan;57(1):91-7
pubmed: 24316951
World J Surg. 2013 Feb;37(2):259-84
pubmed: 23052794
JAMA. 1964 Oct 5;190:25-9
pubmed: 14198806
Ann Intern Med. 2015 May 5;162(9 Suppl):S1-34
pubmed: 25938928
J Clin Nurs. 2002 Sep;11(5):651-6
pubmed: 12201892
Colorectal Dis. 2013 Jun;15(6):733-6
pubmed: 23331852
Orthop Nurs. 2012 Jan-Feb;31(1):12-8
pubmed: 22278644
Int J Technol Assess Health Care. 1986;2(1):53-63
pubmed: 10300718
Arch Surg. 2007 Oct;142(10):969-75; discussion 976
pubmed: 17938311
Clin Infect Dis. 2006 Jun 1;42(11):1544-51
pubmed: 16652311
J Urol. 2012 May;187(5):1662-6
pubmed: 22425122
Clin Colon Rectal Surg. 2013 Sep;26(3):178-81
pubmed: 24436671
JAMA Intern Med. 2018 Aug 1;178(8):1078-1085
pubmed: 29971436
Clin Orthop Relat Res. 1988 Jun;(231):79-82
pubmed: 3370890
Am J Surg. 2010 Mar;199(3):391-4; discussion 394-5
pubmed: 20226917
Anesth Analg. 1999 Jul;89(1):90-7
pubmed: 10389784
Acta Anaesthesiol Scand. 2013 May;57(5):639-45
pubmed: 23432613
J Arthroplasty. 1996 Dec;11(8):882-8
pubmed: 8986564
Colorectal Dis. 2012 Oct;14(10):e727-34
pubmed: 22594524
Clin Nurse Spec. 2010 Jul-Aug;24(4):202-8
pubmed: 20526121
Br J Surg. 2001 Jun;88(6):831-6
pubmed: 11412253
World J Surg. 2013 Feb;37(2):285-305
pubmed: 23052796
Anaesth Intensive Care. 2012 May;40(3):450-9
pubmed: 22577910
Int J Nurs Stud. 2013 Dec;50(12):1589-98
pubmed: 23768410
BMJ Open Qual. 2018 Apr 27;7(2):e000177
pubmed: 29719874
N Engl J Med. 1988 Aug 11;319(6):321-6
pubmed: 3393193
Surg Laparosc Endosc. 1998 Apr;8(2):157-8
pubmed: 9566574
Surg Endosc. 1996 Apr;10(4):432-3
pubmed: 8661796
Clin Nutr. 2005 Jun;24(3):466-77
pubmed: 15896435
Clin Infect Dis. 2011 Jun;52(11):1291-3
pubmed: 21596672
Arch Surg. 2009 Oct;144(10):961-9
pubmed: 19841366
Infect Control Hosp Epidemiol. 2010 Apr;31(4):319-26
pubmed: 20156062
Surg Laparosc Endosc Percutan Tech. 1999 Jun;9(3):184-6
pubmed: 10803996
Hepatogastroenterology. 2013 Nov-Dec;60(128):1873-6
pubmed: 24719920
Clin Orthop Relat Res. 2000 Nov;(380):80-4
pubmed: 11064976
J Urol. 2011 May;185(5):1756-60
pubmed: 21420117
Dis Colon Rectum. 2010 Mar;53(3):321-6
pubmed: 20173480
Am J Surg. 2014 Feb;207(2):288-92
pubmed: 24200291
Orthopedics. 1989 Aug;12(8):1085-7
pubmed: 2771828
Obes Surg. 2013 Jun;23(6):760-3
pubmed: 23306798
Am J Public Health. 1986 Jul;76(7):766-72
pubmed: 3521341
World J Surg. 2013 Feb;37(2):240-58
pubmed: 22956014
J Arthroplasty. 1995 Dec;10(6):732-6
pubmed: 8749753
Surg Endosc. 2013 Jan;27(1):133-8
pubmed: 22810153
Obes Surg. 1996 Feb;6(1):50-53
pubmed: 10731250
Int J Surg Investig. 1999;1(2):157-60
pubmed: 11341636
Surg Endosc. 1998 Nov;12(11):1311-3
pubmed: 9788853
Ann Intern Med. 2002 Jul 16;137(2):125-7
pubmed: 12118969
Surg Endosc. 2013 Apr;27(4):1225-32
pubmed: 23232990
N Engl J Med. 2016 Jun 2;374(22):2111-9
pubmed: 27248619
J Laparoendosc Adv Surg Tech A. 2008 Jun;18(3):373-6
pubmed: 18503369
Surgery. 1999 Feb;125(2):135-41
pubmed: 10026745
Int J Colorectal Dis. 2013 Jul;28(7):1019-26
pubmed: 23371335
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S99-S106
pubmed: 25222905