514 / Prevention of urinary tract infections caused by catheter insertion

CROATIA
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Handling of catheters
There is no specified text here There is no specified text here
Topic of the reported practice
Clinical risk management
Aim and the benefit of the Patient Safety Practice
 
This practice aims to prevent urinary tract infections caused by catheters.
Description of the Patient Safety Practice
 
Definition of the procedure: Introduction urinary catheter is a procedure that is performed in order to undisturbed outflow urine from the bladder.
The purpose of the procedure is to allow undisturbed outflow of urine from the urinary bladder by placing a catheter for urinary retention, incontinence, therapeutic and diagnostic procedures.
The introduction of urinary catheter requires sterile access and also knowledge of the anatomy and physiology of the urinary system.
Urinary catheter may be placed permanently, may be placed occasional or one-time. Placed urinary catheter enables accurate monitoring of diuresis, specific weight, look and smell of urine, flushing of the bladder, and the use of medicaments. Facilitates the taking of urine samples for laboratory tests.
Estimate:
- Characteristics elimination of urine, daily habits, difficulty during urination (retention, oliguria, polyuria ...)
- Impact of urinary incontinence on the occurrence of complications in patients (decubitus ulcers..)
- The impact of medicamenets taken by the patient to the elimination of urine
- Mental and physical condition of the patient
Implementation of intervention:
Prepare all the necessary materials (sterile catheterization aquipment, apropriate sterile catheter, antiseptic for mucosa, alcoholic antiseptic hand, lubricant , disposable sterile and non-sterile gloves)
Before the introduction of the urinary catheter nurse disinfects hands and the patient is placed in the appropriate position. Before the introduction of the catheter make the hygiene of the genitals with foaming chlorhexidine. Below perianal part of body of patients put a sterile compress.
A nurse or doctor puts on sterile gloves and again disinfects with sterile antiseptic . He takes a sterile instrument, accepts sterile urinary catheter (adds nurse who assists in the procedure), the tip catheter coated with sterile lubricant. Don't push catether with a force, it is important to be gentle. When the catheter is introduced nurse who assists adds syringe with the appropriate amount of saline solution according to the manufacturer's recommendation, and the diameter of the catheter.
The nurse who introduced balloon catheter filled with specified amounts of saline solution (in case of a single catheterization is not required).
A nurse assists, observes the distal part of the catheter, removes the protective cover from the urine bag and connects it to a catheter. A nurse who assists puts the urinary bag on the holder and puts the holder on the edge of the bed making sure to be in the lower position of the urinary bladder.
Accommodate patients in a comfortable position and cover it. Document the procedure and the patient's condition.
Procedure and patient's participation: Prior to starting the procedure, explaination is needed so that a patient understands what is going to happen and why they need to be catheterized. It is important that everything is perfectly clear to them. If they have any questions, the medical staff will be happy to answer them.
Patient participations is in the way that he is listening to the instructions what position to take and that he breathes deeply and evenly.
Position for the female patient is in supine position with the knees flexed and separated and feet flat on the bed, about 60cm apart. If this position is uncomfortable, it is necessary to instruct the patient either to flex only one knee and keep the other leg flat on the bed, or spread her legs as far apart as possible. A lateral position may also be used for elderly or disabled patients.
Position for the male patient is in a supine position with legs extended and flat on the bed.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Not known
A measurement after full implementation of the reported practice was obtained
Not known
Evaluation of a "positive" effect of the reported practice on Patient Safety
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
There is no specified text here
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Nursing facility
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Not known
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Relative(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the development of the Patient Safety Practices
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
Yes
Short description of the service users' level of involvement
Collaboration, such as co-designing a Patient Safety Practice or active partnership in implementation
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
WEB SITE
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Strong knowledge in implementation
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Zeljka Dujmic
Country: CROATIA
Organisation: General Hospital"Dr. Josip Benčević" Slavonski Brod
E-mail: zeljka.dujmic@bolnicasb.hr
Phone: 0038535201201
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