Implementation of a Standardized Process of Coude Catheter Insertion Decreases Traumatic Catheterizations.

To address the issue of traumatic foley catheterization we developed and implemented a coude catheter education program for operating room nurses as well as standardize the usage of a coude catheter for male patients. Traumatic catheterization leads to patient morbidity and increased healthcare costs. A retrospective review was conducted to identify all traumatic catherizations over a 6-month period for several surgical services at our institution. A nursing education program was implemented that included basic urological anatomy, coude urethral catheter insertion techniques, and catheter safety. We conducted our trial over a period of 2-months with all catheterizations tracked. Following the trial, the process and outcomes were reviewed and then implemented for all male patients >18 years old requiring indwelling catheter placement in the operating room. On retrospective review there were 18 traumatic foley catheterizations of patients on the three surgical services out of a total 601 catheter placements (3% traumatic placement rate). The total cost of these traumatic catherizations was $27,793 when accounting for additional procedures, supplies, and additional OR time required for each traumatic catheterization. The average cost per patient was $1,544. After full implementation of the process across all operating room services in June 2021 there have been 2038 catheterizations performed using a coude catheter kit with 4 traumatic foley placements through May 2022 (0.2% traumatic catheterization rate). Implementation of the nursing education program and utilization of the coude catheter for all male catheterizations reduces costs, decreases iatrogenic urethral injury, and improves patient safety.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest 1) David Miller – no conflict______________________________________________ 2) Daniel Pelzman -no conflict____________________________________________ 3) Sarah Erpenbeck -no conflict________________________________________________ 4)_ Oluwaseun Orikogbo – no conflict ____________________________________ 5)_ Avisha Risnear – no conflict___________________________________________ 6)__ Jennifer Bonfili – no conflict___________________________________________ 7)____ Kelly Pekala - no conflict_______________________________________________________ 8)_ Avinash Maganty – no conflict____________________________________________ 9)__ Roberta Jones – no conflict_________________________________________________ 10)________ Stephen Jackman -no conflict________________________________________ 11)____ Paul Rusilko -no conflict_______________________________________________