PC-Nurse-DrivenUrinaryCatheterRemoval.docxVIP

 PC- Nurse-Driven Urinary Catheter Removal    Purpose: Reduce catheter associated urinary tract infections (CAUTI). Definitions: CAUTI – A nosocomial infection that can develop in patients with an indwelling urinary catheter. Policy: Patients meeting specific assessment criteria will have the urinary catheter removed by a nurse. Procedure: Assess the need to continue urinary catheter as part of their ongoing assessment using the Nurse-Driven Urinary Catheter Assessment. (See Addendum A). If none of the specified indications for continued catheter use are met, the catheter will be discontinued by the nurse. Continue to reevaluate and assess the need to reinsert the urinary catheter following removal of the urinary catheter. Contact the patient’s physician for further orders if patient is unable to void following catheter removal. Patient/Family Education Patient and/or family will be educated on: Risk of complications associated with urinary catheters. Importance of adequate fluid intake after removal of urinary catheter . Measurement of intake and output to be done to assess the patient’s ability to empty bladder after removal of urinary catheter. Documentation: Nurse to document assessment and removal of urinary catheter and continued reassessment post removal, in the patient’s medical record. Urinary Catheter Assessment Aggressive treatment with diuretics Accurate monitoring of urinary output Management of urinary incontinence in patient with Stage III or greater pressure ulcers End of life/comfort care Gross hematuria within last 24 hours Urologist involved in case/catheter placed by urology/difficult catheterization Post op/post procedure (less than 48 hours prior) Presence of epidural catheter Spinal cord injury/significant immobilization issues Chronic long term indwelling catheter History of urinary retention MD order to continue urinary catheter Indications present? Yes or No Assess Patient for Indications for Co