Texas Health H-E-B Ex- -ates

1. Foley BACKGROUND: This facility struggled with a compliance rate of 49 percent with the SCIP (Surgical Care Improvement Project) Inf-9 measure (urinary catheter removed by end of post operative day 2). Implementation of a catheter removal checklist was started in Q2 2010, and along with clinical judgment of nurses, has significantly improved compliance for the timely discontinuation of urinary catheters. • OBJECTIVE: To improve compliance with SCIP (Surgical Care Improvement Project) Inf-9 measure (removal of urinary catheter by end of post operative day 2) by 20% by the end of Q3 2010. • METHODS: A multi-disciplinary, evidence based approach was utilized in a mid-sized community hospital to create a medical staff approved catheter removal checklist directing nursing staff to initiate removal of urinary catheters as soon as deemed no longer medically necessary by criteria. • RESULTS: Compliance with SCIP Inf-9 increased 15% from the end of Q2 2010 to the end of Q3 2010. The facility has sustained this improvement with greater than 98% compliance with SCIP Inf-9 for one year. • CONCLUSIONS: Specific criteria supporting medical necessity for ongoing urinary catheterization can be organized into a useful tool that gives nursing staff direction in removing catheters at the earliest possible time. Texas Health H-E-B Ex- -ates Patients who have indwelling bladder catheters for more than 2 days postoperatively are 21% more likely to develop UTI, significantly less likely to be discharged to home, and have a significant increase in mortality at 30 days. Source: Specification Manual for National Inpatient Hospital Quality Measures