5. The claim may be made that moving to a shorter catheter would cause problems that would make them impractical. This author polled multiple members of the nursing staff as well as some staff from physical and occupational therapy and reached the general consensus that, in an acute care or physical rehab setting, a shorter line would be at least harmless, and possibly helpful to accommodating necessary activities. More than one physical therapist mentioned that a shorter tube might decrease the trip-hazard aspect of catheters during treatment. 6. Some believe that appropriate catheters do not currently exist and that that is the end of the discussion. In fact, when this author spoke to the customer service representative for the large urinary catheter manufacturer that is the primary vendor for the acute care facility under discussion, the representative said, “We don’t have any smaller catheters. Just cut it. It’s made to be reattach-able.” This of course is not considered to be best practice, especially in an acute care setting. (Al-Hameed, et al., 2018 and Gesmundo, 2016) There are at least four major competitors that sell comparable products, (Bard, n.d.) and while they may or may not currently offer an optimal product, the primary reason companies offer a new product is because of client need. It is quite likely that should the current vendor, as well as several other competitors, be made aware of the need and the rationale for it, that they would consider expanding their product lines to retain or gain a major client. Page 19
Translational Research for Practice and Populations 7. It has also been stated that a major barrier to changing to a shorter catheter is that the decision is not made at the local level, that the facility’s much larger parent company is ultimately responsible for all purchasing decisions and contracts. While this may be true, it is narrow to think that a corporation that encompasses hundreds of medical facilities with thousands of certifications and millions of customer service events would not be interested in change that would make best practice for their patients so much easier. Change has to start somewhere, and one 180-bed acute care hospital might be just the place for it to begin. Application of Kotter’s Change Model, Step 6 Step 6 is to “generate short-term wins.” (Kotter, n.d.,a) Celebrate “early and often!” (Kotter, n.d.,a) The facility must measure where they are first. Then they can track progress and enjoy the victory in every little success. The guiding coalition can set up ways to recognize superior players in both their adherence to best practice and their championship of the cause. As spot checks show that the correct, shorter catheters are in place and that positioning is correct more and more of the time, and as CAUTI rates drop to 0, a factor of the potential moneys saved could be directly allotted in some tangible way to recognize and reward the most successful individuals and teams.
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- Spring '16
- Nursing, urinary tract infection, Catheter, Urinary catheterization