Implementing Educational, Executive and Managerial Strategies (Interventions) to Reduce Urinary Catheter Utilizations in a University Hospital

Background and Objectives This study was conducted with the aim of investigating methods to reduce the use of urinary catheters in hospitalized patients, which can reduce the occurrence of urinary infections. Subjects and Methods This prospective study was conducted during 10 months by collecting information from the files of 694 patients (in two groups before and after the intervention) in the non-Intensive Care Unit wards of a university hospital. The required information before and after the educational and managerial interventions were collected and compared. Results In the pre-intervention phase, 217 out of 347 patients (62.5%) and in the post-intervention phase, 199 out of 347 patients (57.3%) were male. Before the intervention, the average duration of hospitalization and urinary catheter utilization days were 8.7 and 7.9 days, respectively, which were decreased to 7.2 and 6.3 days, respectively, after the intervention. After the intervention, the number of catheters that were placed by the doctor's written order increased significantly (P-value: 0.002); Also, after the intervention, the cases of catheterization with indication increased significantly (P-value: 0.001). The most common indication for urinary catheter insertion was before and during surgery and later, was severe weakness of the patient to get out of bed. Conclusion Combination of educational, executive and managerial interventions can reduce the number of urinary catheter insertion without physician's order and the number of urinary catheter insertion without indication. In this study, the number of cases who used catheter due to inability of getting out of bed, did not change significantly by the interventions.