Need to ask a few questions for a project...

[4evernrs]

I'm not a hospital nurse, and most certainly not an OR nurse (homecare primarily), so I'm stumped by a project I'm working on for a class I'm in.... I had to choose a typical periop procedure that could possibly be changed to promote better patient outcomes.... I chose to propose the utilization of silver-tipped catheters instead of the standard latex caths. Anyway - the point of my post: My instructions for this project say that I should ask for the following answers from hospital personnel:

1) Explain who determined the basis for the practice (of using urinary catheters perioperatively)

2) Explain the rationale for making the decision for the procedure (I think I've already got a pretty good idea)

3) Explain why the practice is performed this way

Any answers/comments/suggestions will be helpful!

Thanks!

[PetiteOpRN]

1) Explain who determined the basis for the practice (of using urinary catheters perioperatively)

This is determined on a case-by-case basis. The surgeon ultimately makes the call. Anesthesia and the circulator do have some input. For instance, if preop forgets to have the patient urinate and the patient mentions needing to go to the bathroom during induction, anesthesia might forcefully request a foley instead of waiting for a urinal or trip to the bathroom (the former is not readily available, the latter might be a 10 minute trip with a patient who already has narcs on board).

2) Explain the rationale for making the decision for the procedure (I think I've already got a pretty good idea)

Length of procedure (>2 hours or >1.5 hours, depending on surgeon preference), type of sedation (generally not needed with a three hour conscious sedation, but is needed for a three hour general), gender (a male who is awake during a craniotomy can use a urinal, while a female is cathed), whether the patient will be discharged immediately or go to the floor (it's easier for me to put a foley in than the floor nurse)

3) Explain why the practice is performed this way

A foley not only keeps the linens/drapes dry (maintaining skin integrity/sterility), it allows anesthesia to continuously monitor kidney perfusion/function, which tells them a lot about the circulatory status of the patient. The patient almost always has antibiotics (unless they are allergic to EVERYTHING), but there is still the risk of infection related to foley use. Silver-tipped foleys decrease the risk of infection, which is great if the patient will need the foley for an extended period of time.

[4evernrs]

PetiteOpRN: You are AWESOME! Thanks soooooo very much!