Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.
Appropriateness
General surgery
Patient safety
Perioperative care
Urinary catheter
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
08
11
2019
revised:
06
01
2020
accepted:
07
01
2020
pubmed:
6
2
2020
medline:
26
11
2020
entrez:
4
2
2020
Statut:
ppublish
Résumé
The Michigan Appropriate Perioperative (MAP) criteria provide guidance regarding urinary catheter use. For Category A (e.g., laparoscopic cholecystectomy), B (e.g., hemicolectomy), and C (e.g., abdominoperineal resection) procedures, recommendations are to avoid catheter, remove POD 0 or 1, and remove POD 1-4, respectively. We applied MAP criteria to statewide registry data to identify improvement targets. Retrospective cohort study of risk-adjusted catheter use and duration for appendectomy, cholecystectomy, and colorectal resections in 2014-2015 from 64 Michigan hospitals. 5.5% of 13,032 Category A cases used urinary catheters, including 26.9% of open appendectomies. 94.5% of 1,624 Category B cases used catheters (31.2% remained after POD 1). 98.3% of 700 Category C cases used catheters (4.6% remained POD5+). Variation in duration of use persisted after risk adjustment. Perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.
Sections du résumé
BACKGROUND
The Michigan Appropriate Perioperative (MAP) criteria provide guidance regarding urinary catheter use. For Category A (e.g., laparoscopic cholecystectomy), B (e.g., hemicolectomy), and C (e.g., abdominoperineal resection) procedures, recommendations are to avoid catheter, remove POD 0 or 1, and remove POD 1-4, respectively. We applied MAP criteria to statewide registry data to identify improvement targets.
METHODS
Retrospective cohort study of risk-adjusted catheter use and duration for appendectomy, cholecystectomy, and colorectal resections in 2014-2015 from 64 Michigan hospitals.
RESULTS
5.5% of 13,032 Category A cases used urinary catheters, including 26.9% of open appendectomies. 94.5% of 1,624 Category B cases used catheters (31.2% remained after POD 1). 98.3% of 700 Category C cases used catheters (4.6% remained POD5+). Variation in duration of use persisted after risk adjustment.
CONCLUSIONS
Perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.
Identifiants
pubmed: 32008720
pii: S0002-9610(20)30009-X
doi: 10.1016/j.amjsurg.2020.01.008
pmc: PMC7668235
mid: NIHMS1629329
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
706-713Subventions
Organisme : AHRQ HHS
ID : K08 HS019767
Pays : United States
Organisme : AHRQ HHS
ID : P30 HS024385
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS018334
Pays : United States
Organisme : AHRQ HHS
ID : T32 HS000053
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest Honoraria: Dr. Meddings has reported receiving honoraria from hospitals and professional societies devoted to complication prevention for lectures and teaching related to prevention and value-based purchasing policies involving catheter-associated urinary tract infection and hospital-acquired pressure ulcers. Intellectual Property/Product Development: The research of Dr. Meddings involves the development of products to improve patient safety by reducing hospital-acquired complications. Dr. Meddings has an issued patent on one product that aims to reduce urinary catheter associated complications. Dr. Meddings and Ms. Ameling recently applied for a patent involving a device to reduce hospital-acquired pressure ulcers.
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