An Examination of the Barriers to and Facilitators of Implementing Nurse-Driven Protocols to Remove Indwelling Urinary Catheters in Acute Care Hospitals
Copyright © 2020 The Joint Commission. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Urinary catheter nurse-driven protocols (UCNDPs) for removal of indwelling urinary catheters (IUCs) can potentially prevent catheter-associated urinary tract infections (CAUTIs). However, they are used inconsistently. The objective of this study was to examine the barriers to and facilitators of implementation of UCNDPs in acute care hospitals.
METHODS: Between September 2017 and January 2019, researchers interviewed 449 frontline staff (nurses, physicians), managers, and executives from 17 US hospitals to better understand their experiences implementing, using, and overseeing use of UCNDPs. Our semistructured interview guide included questions about management practices and policies regarding enactment of a UCNDP.
RESULTS: Although the features of UCNDPs differed across hospitals, the analysis revealed that hospitals experienced common issues related to implementing and consistently using UCNDPs as a result of three major barriers: (1) nurse deference to physicians, (2) physician push-back, and (3) miscommunication about IUC removal. Interviewees also described several important facilitators to help overcome these barriers: (1) training care team members to use the UCNDP, (2) discussing IUC necessity and UCNDP use during rounds, (3) reminding care team members to follow UCNDPs, and (4) developing buy-in for UCNDP use across the hospital.
CONCLUSION: Although UCNDPs are fundamental in efforts to reduce and prevent CAUTIs, hospitals can proactively support their implementation and use by developing the skills that care team members need to enact UCNDPs when patients meet the clinical indications for removal, and increasing awareness about the value and importance of such protocols for reducing CAUTIs and improving patient safety.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:46 |
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| Enthalten in: |
Joint Commission journal on quality and patient safety - 46(2020), 12 vom: 28. Dez., Seite 691-698 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
DePuccio, Matthew J [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 28.07.2021 Date Revised 30.05.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jcjq.2020.08.015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM315340843 |
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| 100 | 1 | |a DePuccio, Matthew J |e verfasserin |4 aut | |
| 245 | 1 | 3 | |a An Examination of the Barriers to and Facilitators of Implementing Nurse-Driven Protocols to Remove Indwelling Urinary Catheters in Acute Care Hospitals |
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| 500 | |a Date Revised 30.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 The Joint Commission. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Urinary catheter nurse-driven protocols (UCNDPs) for removal of indwelling urinary catheters (IUCs) can potentially prevent catheter-associated urinary tract infections (CAUTIs). However, they are used inconsistently. The objective of this study was to examine the barriers to and facilitators of implementation of UCNDPs in acute care hospitals | ||
| 520 | |a METHODS: Between September 2017 and January 2019, researchers interviewed 449 frontline staff (nurses, physicians), managers, and executives from 17 US hospitals to better understand their experiences implementing, using, and overseeing use of UCNDPs. Our semistructured interview guide included questions about management practices and policies regarding enactment of a UCNDP | ||
| 520 | |a RESULTS: Although the features of UCNDPs differed across hospitals, the analysis revealed that hospitals experienced common issues related to implementing and consistently using UCNDPs as a result of three major barriers: (1) nurse deference to physicians, (2) physician push-back, and (3) miscommunication about IUC removal. Interviewees also described several important facilitators to help overcome these barriers: (1) training care team members to use the UCNDP, (2) discussing IUC necessity and UCNDP use during rounds, (3) reminding care team members to follow UCNDPs, and (4) developing buy-in for UCNDP use across the hospital | ||
| 520 | |a CONCLUSION: Although UCNDPs are fundamental in efforts to reduce and prevent CAUTIs, hospitals can proactively support their implementation and use by developing the skills that care team members need to enact UCNDPs when patients meet the clinical indications for removal, and increasing awareness about the value and importance of such protocols for reducing CAUTIs and improving patient safety | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 700 | 1 | |a Gaughan, Alice A |e verfasserin |4 aut | |
| 700 | 1 | |a Sova, Lindsey N |e verfasserin |4 aut | |
| 700 | 1 | |a MacEwan, Sarah R |e verfasserin |4 aut | |
| 700 | 1 | |a Walker, Daniel M |e verfasserin |4 aut | |
| 700 | 1 | |a Gregory, Megan E |e verfasserin |4 aut | |
| 700 | 1 | |a DeLancey, John Oliver |e verfasserin |4 aut | |
| 700 | 1 | |a McAlearney, Ann Scheck |e verfasserin |4 aut | |
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