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Decreasing Urinary Catheterization in Kidney Injury (DUCKI): an effectiveness and deimplementation study in the

Calvin Patten, Tiffany E Rosenzweig, Carrie Sona

Medrxiv : the Preprint Server for Health Sciences

|February 20, 2025

Summary

This summary is machine-generated.

The DUCKI program significantly reduced indwelling urinary catheter use in ICU patients with kidney injury by 67%, maintaining low rates over two years. This implementation science approach effectively sustains reduced catheterization practices in critical care settings.

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Area of Science:

Implementation Science
Critical Care Medicine
Nephrology

Background:

Indwelling urinary catheter use remains high in surgical ICUs despite national efforts.
The sustainability of decreased catheter utilization after hospital initiatives is often unclear.

Purpose of the Study:

To evaluate the effectiveness of the Decreasing Urinary Catheters in Kidney Injury (DUCKI) program, developed using implementation science.
To assess the sustained impact of DUCKI on indwelling catheterization rates in ICU patients with acute kidney injury (AKI) and end-stage renal disease (ESRD).

Main Methods:

A hybrid 1 implementation study design was employed.
Outcomes were assessed via chart review comparing 2021 and 2023 cohorts of DUCKI-eligible patients.
Physician and nurse surveys evaluated the implementation process and stakeholder perceptions.

Main Results:

The DUCKI protocol reduced indwelling catheterization rates in eligible patients from 80% to 10% (2021) and sustained it at 9% (2023).
Overall unit catheterization rates decreased from 74% pre-implementation to 66% in 2023.
No serious adverse events were reported; stakeholders found the program acceptable, with a minority reporting workflow burden.

Conclusions:

The DUCKI program successfully and sustainably decreased indwelling catheterization rates in ICU patients with AKI/ESRD.
Implementation science is an effective strategy for adopting and sustaining evidence-based practices like DUCKI.
The DUCKI protocol offers a safe method to minimize catheter use in specific ICU populations and has potential for broader application.