Nurse-Led Evidence-Based Quality Improvement Programme to Reduce Urinary Leakage in Intensive Care Unit Patients with...

Area of Science:

• Critical Care Medicine
• Nursing Research
• Quality Improvement Science

Background:

• Indwelling urinary catheters are essential in intensive care units (ICUs).
• Urinary leakage around catheters is a common complication in critically ill patients, influenced by factors like mechanical ventilation, sedation, increased intra-abdominal pressure, and altered consciousness.
• Nurses require specialized knowledge and skills for effective prevention and management of urinary leakage.

Purpose of the Study:

• To decrease the incidence of urinary leakage in ICU patients.
• To develop and implement a nurse-led, evidence-based Urinary Leakage Bundle.
• To enhance patient outcomes through improved catheter management protocols.

Main Methods:

• Utilized the Evidence-based Continuous Quality Improvement and Promoting Action on Research Implementation in Health Services frameworks.
• Conducted a quasi-experimental study in a 20-bed comprehensive ICU.
• Evaluated outcomes including patient urinary leakage rates, nurses' knowledge, attitudes, practices, and adherence to bundle interventions.

Main Results:

• The Urinary Leakage Bundle intervention significantly improved ICU nurses' knowledge, attitudes, and practice scores (from 3.36±0.31 to 4.40±0.31).
• The urinary leakage rate decreased substantially, from 25.4% at baseline to 13.3% post-implementation.
• Adherence to the Urinary Leakage Bundle, particularly in catheter selection, securement, and bypassing management, showed significant improvement.

Conclusions:

• The nurse-led, evidence-based Urinary Leakage Bundle is feasible for routine ICU care.
• Implementation of the bundle led to enhanced nurses' knowledge, attitudes, and practices, improved adherence to care processes, and reduced urinary leakage rates.
• The study findings suggest the Urinary Leakage Bundle's potential for effective implementation in other clinical settings.