Enhancing Voiding Trial Adherence Using QR Code-Based Video Education

Voiding trials are critical for identifying postoperative urinary retention following pelvic surgery. However, inconsistent nursing execution due to confusing protocols or complex electronic order sets can lead to poor adherence, patient harm, and unnecessary catheter use.

The objective of this study was to determine whether providing nursing staff with quick response (QR) code-linked instructional videos improves adherence to postoperative voiding trial protocols.

A pre-post quality improvement study was conducted over 3 months at 2 tertiary care hospitals. QR codes linked to video tutorials for active, passive, and suprapubic tube voiding trials were attached to patient charts, catheter bags, and placed throughout clinical areas. Adherence to voiding trial protocols was assessed by accurate and complete documentation in the electronic medical record. Adherence rates before and after the intervention were compared using the Fisher exact test and one-way ANOVA.

A total of 150 patients were included (61 preintervention, 89 postintervention). Overall adherence improved from 44.3% to 76.4% ( P < 0.001). Significant improvements were observed in passive voiding trials (51.9% vs 85.0%, P = 0.005), active voiding trials (30.8% vs 66.6%, P = 0.046), and trials completed in both the postanesthesia care unit ( P = 0.006) and inpatient floor settings ( P = 0.008).

QR code-linked instructional videos significantly improved nursing adherence to voiding trial protocols across multiple trial types and care locations. This low-cost intervention may enhance postoperative care quality and offers a practical model for improving nursing protocol adherence in pelvic floor surgery.