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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.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|March 1, 1992
PubMed
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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.

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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.