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Using quality improvement methods to implement guidelines to decrease the proportion of urinary retention in orthopaedic care
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Ryhov County Hospital, Jönköping, Sweden.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
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2017 (English)In: International Archives of Nursing and Health Care, ISSN 2469-5823, Vol. 3, no 1, IANHC-3-065Article in journal (Refereed) Published
Abstract [en]

In patients treated with indwelling urethral catheter (IUC), complications such as catheter associated urinary tract infections are common, while underuse of IUC may cause harmful urinary retention (UR). A quality improvement (QI) program called ‘Indwelling urethral catheter (IUC) - only when needed’ was developed in Jönköping County Council, Sweden, aiming at creating a new approach: hospital staff should be able to identify and manage patients with risk of UR, prevent UR or treat UR without delay, and only use urinary IUCs on appropriate indications. The aim of this study was to describe the process of application of the quality improvement program. The Model for Improvement was used, and process coaches were appointed in the participating units. Their training was based on clinical issues and facts about UR, IUCs, guidelines, QI methods and measurements. Data were collected through prospective and retrospective patient record reviews, and differences were analyzed by inferential statistics.

Before the intervention, only two patients out of 296 were cared for following the guidelines perfectly. During the intervention, adherence to guidelines showed a rising trend, and reached a new stable level, with an average of 67% adherence to guidelines. A systematic improvement program supported by coaches and improvement tools can increase the adherence to new guidelines and incorporate them into local practice. This study also shows that adherence to guidelines can improve patient safety, in this case a decreased risk for and incidence of UR in an orthopaedic patient population.

Place, publisher, year, edition, pages
ClinMed International Library , 2017. Vol. 3, no 1, IANHC-3-065
Keyword [en]
Guidelines, Indwelling urinary catheters, Model for improvement, Orthopaedic care, Quality improvement, Urinary retention
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-35282DOI: 10.23937/2469-5823/151006OAI: oai:DiVA.org:hj-35282DiVA: diva2:1086224
Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2017-03-31Bibliographically approved

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Andersson, Ann-ChristineElg, MattiasAndersson-Gäre, Boel
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The Jönköping Academy for Improvement of Health and WelfareHHJ, Dep. of Nursing ScienceHHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare)
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CiteExportLink to record
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Citation style
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