Preventing Traumatic Urinary Catheter Insertion Through a Computerized Ordering System: Quasi-experimental Study From a Tertiary Academic Center

Background: Iatrogenic urethral injury is a well-known risk of urinary catheter insertion. Associated morbidities include stricture formation, catheter associated infection, risk for instrumentation, and extended length of stay. Yet, insufficient attention is paid to its prevention. Objective: This study aimed to assess the effectiveness of a computerized ordering system in reducing iatrogenic urethral injuries in men at high risk for iatrogenic urethral injury from traumatic catheterization. Methods: A pre-post study was performed to assess the impact of a computerized ordering system that recommended a ۱۶ Fr Coudé-tip catheter be used instead of the standard ۱۶ Fr Foley catheter for men at high risk for difficult catheter insertion. The intervention was implemented in October ۲۰۱۲. The rates of traumatic and non-traumatic insertion consults were compared between the pre-intervention (۱۰/۱/۲۰۱۰-۰۹/۳۰/۲۰۱۱) and post-intervention (۱۰/۱/۲۰۱۲-۹/۳۰/۲۰۱۳) time periods. Results: The results showed that ۷۸.۵% of patients with iatrogenic urethral injury possessed at least one identified risk factor for difficult catheterization. There was no significant difference in frequency of traumatic or non-traumatic insertion consults between the pre- and post-intervention cohorts. Conclusion: The current study highlights the possibility of preventing traumatic insertions by targeting men at high risk for iatrogenic injury. Without a simultaneous plan for improving catheter placement awareness and training, any change in the ordering process is unlikely to succeed on its own.

کلیدواژه ها:

Urinary Catheterization ، Iatrogenic Disease ، Urethra ، Male