Lose the Tube: Hospital Adopts New Medical Directive to Improve Seniors’ Health

Andrea Raynak, Clinical Nurse Specialist, Chronic Disease Prevention and Management.

A patient may require a urinary catheter for a variety of reasons. A new medical directive empowers nurses to remove the catheter when it is no longer needed, which can reduce incidences of urinary tract infections.

Over-use of urinary catheters has been a common trend in Hospitals, and one that particularly affects senior patients. Thunder Bay Regional Health Sciences Centre is committed to improving seniors’ health and has pledged to “lose the tube”; an initiative that will improve patient care by reducing the length of time a urinary catheter is in use.

What is a medical directive?

Medical directives are written orders to perform treatments or procedures on patients when specific conditions are met.

“Research has shown that patients greatly benefit from early removal of unnecessary catheters. It not only reduces the risks of infection, but also enables patients to be mobilized much sooner,” said George Fieber, Nursing Practice Lead. “This new medical directive, introduced and championed by Dr. Zaki Ahmed and Dr. Margaret Woods, empowers nurses to make an informed judgment call about how soon catheters can be safely removed.”

The new process was based on a toolkit developed by Choosing Wisely Canada in association with the Canadian Society of Internal Medicine. It supports physicians and nurses in three areas of focus:

  1. Early removal of unnecessary urinary catheters on inpatient wards
  2. Restrictive insertion of urinary catheters in operating rooms
  3. Restrictive insertion of urinary catheters in emergency departments

“We’re building on the best practices and directives provided by the toolkit in order to better address the needs of our Hospital, and the patient population that we serve,” said Fieber. “This is a great initiative that will help improve the experiences of our senior patients and is reflective of our Patient and Family Centred Care philosophy.”