Nurse-Driven Process for the Successful Removal of Urinary Catheters Among Elderly Patients After Hip Fracture Surgery: A Quality Improvement Project

J Nurs Care Qual. 2025 Jan-Mar;40(1):E1-E7. doi: 10.1097/NCQ.0000000000000799. Epub 2024 Aug 1.

Abstract

Background: Hip fracture is a major health concern and the use of an indwelling urinary catheter (IUC) constitutes a significant burden on elderly patients undergoing hip fracture surgery.

Local problem: The institution had a high rate of urinary tract infection (UTI) and IUC reinsertion after hip fracture surgery.

Methods: A pre/post-implementation design was used for this quality improvement initiative.

Interventions: A nurse-driven process was developed and implemented to improve the successful removal of IUC among patients after hip fracture surgery.

Results: There was a significant reduction in post-operative urinary retention ( P = .042), UTI rate ( P = .047), and IUC reinsertion ( P = .042) in the post-implementation group. IUC duration decreased by 1.1 days, however this was not significant ( P = .206). Nurse compliance with following the new process was 93.3%.

Conclusion: The nurse-driven process designed for elderly patients following hip fracture surgery presents a promising approach to reducing IUC reinsertion rates and UTI.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Catheters, Indwelling / adverse effects
  • Device Removal* / methods
  • Device Removal* / nursing
  • Female
  • Hip Fractures* / nursing
  • Hip Fractures* / surgery
  • Humans
  • Male
  • Quality Improvement*
  • Urinary Catheterization* / adverse effects
  • Urinary Catheterization* / nursing
  • Urinary Catheters* / adverse effects
  • Urinary Tract Infections / nursing
  • Urinary Tract Infections / prevention & control