Scenario 9
Kathy was rounding for compliance with the new bladder bundle that was implemented on her unit. She noticed what she believed to be an inappropriate indication for indwelling urinary catheter usage on the log documented by the primary nurse caring for the patient. The reason listed was the physician’s desire to continue the urinary catheter based on his belief that the patient was at risk for falling if she were to ambulate to the bathroom without asking for assistance. This particular reason for continuing the catheter was not on their hospital’s list of indications approved by the Medical Executive Committee, nor is it recommended as a reason for urinary catheterization in the CDC Guideline for the Prevention of Catheter-Associated Urinary Tract Infections, 2009.

Question:
What should Kathy do?

  1. Note the documentation and continue with her rounds.
  2. Speak to the nurse caring for the patient to determine if she has spoken to the physician regarding her documentation of the indication to continue the urinary catheter.
 
 

Correct Answer

Often a urinary catheter may be used as a “restraint” or for nursing convenience. Just as it is important for the nurse to understand the need for urinary catheterization, it is equally important for the physician to understand indications for usage.

Learning Points

  • The primary nurse caring for the patient or the charge nurse can speak with the physician during patient care rounds. The physician can then be notified that her rationale for continuing the urinary catheter is not approved by the medical leadership and that there are other alternatives to urinary catheterization that are safe for patient care.
  • Many hospitals have decreased patient falls by implementing nursing rounds. The nurse rounds every 2 hours to assess his/her patient needs for pain control and the need to void, among other factors.
  • By anticipating patient needs, patient safety and patient satisfaction can be achieved.