Using appropriateness criteria to identify opportunities to improve perioperative urinary catheter use.

Am J Surg

Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Medicine, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA; Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA; Patient Safety Enhancement Program for the University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.

Published: September 2020

Background: The Michigan Appropriate Perioperative (MAP) criteria provide guidance regarding urinary catheter use. For Category A (e.g., laparoscopic cholecystectomy), B (e.g., hemicolectomy), and C (e.g., abdominoperineal resection) procedures, recommendations are to avoid catheter, remove POD 0 or 1, and remove POD 1-4, respectively. We applied MAP criteria to statewide registry data to identify improvement targets.

Methods: Retrospective cohort study of risk-adjusted catheter use and duration for appendectomy, cholecystectomy, and colorectal resections in 2014-2015 from 64 Michigan hospitals.

Results: 5.5% of 13,032 Category A cases used urinary catheters, including 26.9% of open appendectomies. 94.5% of 1,624 Category B cases used catheters (31.2% remained after POD 1). 98.3% of 700 Category C cases used catheters (4.6% remained POD5+). Variation in duration of use persisted after risk adjustment.

Conclusions: Perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668235PMC
http://dx.doi.org/10.1016/j.amjsurg.2020.01.008DOI Listing

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