On your next shift, take a moment and think about each patient that gets a Foley. Can you avoid it? If it has served its purpose, can you take it out? The evidence to reduce Foley placement is strong enough that ACEP made it one of the five recommendations for emergency medicine in the Choosing Wisely campaign. If you want to learn more about how to reduce Foley use in the ED or want your ED to join a national quality improvement effort, check out the On the CUSP: STOP CAUTI collaborative (www.onthecuspstophai.org/on-the-cuspstop-cauti/emergency-department-improvement-intervention) for great resources on best practices to avoid Foleys and minimize CAUTI.
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ACEP Now: Vol 33 – No 02 – February 2014
Dr. Lin is an attending emergency physician and a fellow in the Division of Health Policy Research and Translation in the Department of Emergency Medicine, Brigham and Women’s Hospital in Boston. She also serves as an instructor at Harvard Medical School.
Dr. Schuur is Vice Chair of Quality and Safety and Chief of the Division of Health Policy Research and Translation in the Department of Emergency Medicine, Brigham & Women’s Hospital in Boston. He also serves as assistant professor at Harvard Medical School.
References
- National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary, Table 19. Available at: http://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2010_ed_web_tables.pdf. Accessed February 4, 2014.
- Hazelett SE, Tsai M, Gareri M, Allen K. The association between indwelling urinary catheter use in the elderly and urinary tract infection in acute care. BMC Geriatr. 2006;6:15.
- Gardam MA, Amihod B, Orenstein P, et al. Overutilization of indwelling urinary catheters and the development of nosocomial urinary tract infections. Clin Perform Qual Health Care. 1998;6:99-102.
- Gokula RR, Hickner JA, Smith MA. Inappropriate use of urinary catheters in elderly patients at a midwestern community teaching hospital. Am J Infect Control. 2004;32:196-199.
- Gould CV, Umscheid CA, Agarwal RK, et al. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol. 2010;31:319-326.
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