Background
Although infections related to urinary catheters are getting more attention due to public reporting and hospital penalties, there is less recognition that noninfectious complications related to the trauma of catheter placement and removal are as common as urinary tract infections – and often have long-lasting consequences for patients with abnormal bladder emptying and discomfort. Furthermore, we have heard from surgeons that – while urinary catheter overuse and injury are problems – the most common problem they see in their practices is urinary retention, and they have expressed interest in guidelines or pathways to guide the management of this common problem.
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After being funded by an Agency for Healthcare Research and Quality (AHRQ) grant, the Surgical Urinary Catheter Care Enhancement Safety Study (SUCCESS) was developed and led by Dr. Jennifer Meddings to improve the safety of perioperative urinary catheters, by reducing catheter use and catheter-associated complications, and improving postoperative urinary retention management. This work complements current CAUTI surveillance measures.
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SUCCESS Intro Video
Toolkit Implementation
Better tools are needed to measure and reduce perioperative urinary catheter use, as well as manage postoperative urinary retention and urinary catheter-associated complications. A comprehensive toolkit was developed, implemented, and evaluated in collaboration with a pilot group of Michigan Surgical Quality Collaborative (MSQC) hospitals’, surgeons, and nurses. The novel measures and toolkit could dramatically reduce common, costly, and morbid complications related to perioperative urinary catheter use, adaptable to many other surgical procedures, to improve the safety of our most vulnerable patients.
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The toolkit intervention will address clinician knowledge and urinary catheterization skills, as well as communication and implementation challenges anticipated to impact catheter use in different types of perioperative clinical settings. This intervention aims to reduce inappropriate perioperative urinary catheter use, catheter-associated complications including infections and catheter-associated trauma, and improve the management of postoperative urinary retention.
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Toolkit Components
SUCCESS Toolkit Table of Contents (new 4/18/2024)
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Pre-Implementation
- SUCCESS Kickoff Slides Template (updated 3/1/2024 with new MAP poster). We developed this Value Proposition presentation to help engage support for the project from hospital leadership, frontline providers, and other stakeholders.
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- Urinary Catheter GPS (Guide to Patient Safety) Interactive Tool
- SUCCESS Toolkit Flyer (new 3/1/2024)
Appropriate Catheter Use
- MAP poster (Perioperative Urinary Catheter Use Guide) (updated 3/1/2024)
- Alternatives to Indwelling Catheters (updated 4/8/2024)
- BladderSafe mobile app (available in Google Play Store or the Apple App Store)
Management of Postop Retention
- Retention Algorithm (updated 1/16/2024)
- Voiding Trial Algorithm (updated 4/23/2024)
Avoiding Catheter Trauma
- Safe Insertion booklet (2023)
- Coudé Catheter Insertion One-pager (new 9/10/2024)
Miscellaneous
- SUCCESS Video Repository (updated 4/16/2024)
Need More Information?
Please contact Jessica Ameling at jameling [@] med.umich.edu if you would like more information.
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Internet Citation
SUCCESS Toolkit for Enhancing Urinary Catheter Appropriateness and Safety for Adult Surgical Patients. Content last reviewed November 2024. A Collaboration between the Michigan Surgical Quality Collaborative (MSQC) and University of Michigan SUCCESS Researchers, Ann Arbor, MI. https://bladdersafe.org/success.html
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