Engaging the emergency department to improve indwelling urinary catheter use: A detailed protocol

Since more than half of hospital admissions come through the Emergency Department (ED), avoiding placement of unnecessary urinary catheters in the ED may significantly reduce catheter use among hospitalized patients.

The main goal is to promote placement of urinary catheters based on appropriate indications and compliance with aseptic insertion technique. The process includes establishing clear guidelines for urinary catheter use, adopting guidelines by the ED, engaging ED physicians and nurses, and educating them on appropriate indications and aseptic insertion technique. Having champions from the ED – ideally, a nurse and physician – will be extremely helpful in your improvement efforts.

Evaluation of continued need of the catheter is encouraged prior to patient transfer from the ED to other hospital units.  Indications for urinary catheter use are based on the 2009 Healthcare Infection Control Practices Advisory Committee (HICPAC) guidelines.

Appropriate Urinary Catheter Placement in the Emergency Department