Implementation of a Process of Coude Catheter Insertion Decreases Traumatic Catheterizations

INTRODUCTION: Traumatic Foley catheterization leads to patient morbidity and increased healthcare costs. To address this issue, we sought to develop and implement a coude catheter education program for operating room nurses as well as standardize the usage of a coude catheter for male patients. METHODS: A retrospective review was conducted to identify all traumatic catheterizations during a 6-month period for the following surgical services: neurosurgery, trauma, and surgical oncology at our institution. At the initiation of the trial, a nursing education program was implemented. First, we conducted a short trial to assess for gaps in our process, after which we implemented the program for all male patients more than 18 years of age needing catheterization in the operating room.RESULTS: On retrospective review, there were 18 traumatic Foley catheterizations of patients on the 3 surgical services. The total cost of these traumatic catheterizations was $41,353 when accounting for additional procedures, supplies, and additional OR time required for each traumatic catheterization. The average cost per patient was $2,297. After full implementation of the process across all operating room services in June 2021, there have been 1201 catheterizations performed using a coude catheter kit with 1 traumatic Foley placement through January 2022. CONCLUSION: Implementation of the nursing education program and use of the coude catheter for all male catheterizations reduces costs, minimizes risk of traumatic male urethral catheterization, and improves patient safety. Next steps include implementing this process for all male inpatients more than 18 years of age at our institution.