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Does indication sheet reduce unnecessary urethral catheterization?

S Danchaivijitr1, S Chokloikaew, T Tangtrakool

  • 1Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Insights

An indication sheet effectively reduced unnecessary urethral catheterizations in Thai hospitals. While overall rates didn't change, doctors adopted the sheet, improving appropriate procedure use.

Area of Science:

  • Medical Practice
  • Clinical Decision-Making
  • Healthcare Quality Improvement

Background:

  • Urethral catheterization is a common procedure with potential for inappropriate use.
  • Standardizing indications for catheterization is crucial for patient safety and resource management.

Purpose of the Study:

  • To evaluate the impact of an indication sheet on doctors' decisions regarding urethral catheterization.
  • To assess the effectiveness of an indication sheet in reducing catheterization without proper indications.

Main Methods:

  • A study involving 16,959 patients across thirteen randomly selected hospitals in Thailand.
  • Implementation of an indication sheet for doctors ordering urethral catheterization between April and May 1989.
  • Comparison of catheterization rates and appropriateness between control and experimental groups.

Main Results:

  • The overall rate of urethral catheterization did not significantly change.
  • Catheterization without proper indications decreased from 27.0% in the control group to 14.3% in the experimental group.
  • The indication sheet was accepted in 96.5% of instances, with order reversals in only 0.8% of cases.

Conclusions:

  • The indication sheet is well-accepted by physicians.
  • The use of an indication sheet can significantly reduce the incidence of urethral catheterization performed without appropriate medical indications.

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