Sustained reductions in urinary catheter use over 5 years: Bedside nurses view themselves responsible for evaluation of catheter necessity

Background Multiple approaches are needed to improve urinary catheter use and sustain compliance with the appropriate indications for catheter use. Methods We evaluated the effect of 3 interventions over 5 years: a nurse-driven multidisciplinary effort for early urinary catheter removal, an intervention in an emergency department to promote appropriate placement, and twice-weekly assessment of urinary catheter prevalence with periodic feedback on performance for nonintensive care units. We also assessed the views of bedside nurses, case managers, and nurse managers with respect to appropriate catheter use, how often need is assessed, and who they consider responsible for the evaluation of urinary catheter need. Results There was a significant reduction in urinary catheter use from 17.3%-12.7% during the 5-year period (linear regression with time as independent variable, R 2 , 0.61; P 70% of the time. Conclusions A multifaceted approach to promote appropriate urinary catheter use is associated with sustained reductions in catheter use. Bedside nurses view themselves responsible for the evaluation of catheter presence and need.