TL13EOa
Visibility, Accessibility, and Communication TL13EO
Using the required empirical outcomes (EO) presentation format, provide one example of an improvement in patient care or the nursing practice environment, associated with communication between the clinical nurse(s) and the CNO.
Example a: Clinical Nurses Communicate with Chief Nursing Officer to Improve the Nursing Practice Environment with External Male Catheters
Problem
At Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS), there was an increase in complaints from clinical nurses and patient care technicians (PCT) on all inpatient units that use external male catheters, regarding the current condom catheter used for male patients.
Pre-Intervention
In February 2024, Teresa Lambert, MBA, BSN, RN, Vice President of Patient Care Services, Assistant Chief Nursing Officer (role of CNO), was made aware of the clinical nurse and PCT dissatisfaction with the current product used for male external catheters at CHI SVHS through discussions in the Interprofessional Council (IPC) meeting with Brooke Rowland, BSN, RN, CCRN, Clinical Nurse, Surgical Intensive Care Unit (SICU). T. Lambert requested a baseline survey be conducted for clinical nurses and PCTs to gather information on the current product.
The survey was available from February 29 to March 6, 2024, via a Google form link to clinical nurses and PCTs in all inpatient units. The survey included two respondent statements using a Likert Scale ranging from 1 (strongly disagree) to 5 (strongly agree) and three questions using free text for responses. Survey statements and questions included:
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The current external male catheters are easy to use.
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I am satisfied with the current external male urinary catheters.
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On average, how often during a shift do you have to replace a male's external urinary catheter?
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What do you like the most about the current external male urinary catheters?
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Please list any concerns you have with the current external male urinary catheters.
Survey results were reviewed in the March IPC meeting. Results showed 23 nurses participated in the survey and indicated that they were not satisfied with the current product and that the products were ill-fitting, leaked, and required frequent replacement.
T. Lambert took the information obtained from the survey and began collaborating with James Martin, Manager of Supply Chain Operations, to find an alternate product replacement for the male external catheter to improve the nurse practice environment. Martin also confirmed his team had heard negative feedback about the current product from the clinical nurses and PCT. T. Lambert requested Martin bring samples of alternative male external catheter options to the March IPC meeting for the clinical nurses to be involved in providing feedback on which product they preferred.
The February 29 to March 6, 2024 (seven days) baseline (pre-) nurse satisfaction survey data showed 65.2% of inpatient clinical nurses either disagree or strongly disagree with the statement: “I am satisfied with the current external male urinary catheter.” The nurse satisfaction survey response percentage was calculated as the number of nurses that responded disagree or strongly disagree, divided by the total number of nurses that responded to the survey question, multiplied by 100.
Goal Statement
Decrease the CHI SVHS inpatient nurse satisfaction survey response percentage of disagree or strongly disagree with the survey statement: “I am satisfied with the current external male urinary catheter.”
Participants
Male External Catheter Work Group
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Name/Credentials |
Discipline |
Title/Role |
Department |
Teresa Lambert, MBA, BSN, RN |
Nursing |
Vice President of Patient Care Services, Assistant Chief Nursing Officer (role of CNO) |
Administration |
Brooke Rowland, BSN, RN, CCRN |
Nursing |
Clinical Nurse |
Surgical ICU |
James Martin |
Supplies |
Manager of |
Central Stores |
Laura McConnell, MSN, RN, CMSRN |
Nursing |
Clinical Nurse, Patient Care Coordinator |
2W Oncology/ Renal |
Kaitlyn Atkins, MSN, RN, CPN |
Nursing |
Clinical Director of Nursing |
Nursing Admin. |
Logan Jenkins, BSN, RN, CCRN |
Nursing |
Clinical Nurse, |
Surgical ICU |
Amy Harkness, |
Nursing |
Clinical Nurse |
Emergency |
Delana Lambert, MNSc, RN, ACNS-BC |
Nursing |
Clinical Nurse Educator |
Clinical Education |
Description of the Intervention
March 7 to April 2, 2024
Martin brought two different BD male external catheters for the clinical nurses to see and ask questions about at the IPC meeting. One was a SureStep™ condom catheter and the other was the PureWick™ male external catheter. A few IPC clinical nurse members voiced previously, using the PureWick™ male external catheter, and shared how patients, clinical nurses, and PCTs liked them.
The PureWick™ male external catheter was easy to use, did not leak, did not have to be replaced throughout the shift, and size was not an issue. They did not have any of the issues reported with the current condom catheters. The group voted unanimously for the PureWick™ male catheter. T. Lambert requested Martin to bring the Purewick™ male catheter into CHI SVHS immediately. In addition, literature supported increased patient and caretaker satisfaction with the PureWick™ male external catheter.
- Martin reached out to Delana Lambert, MNSc, RN, ACNS, Clinical Educator, to get in touch with the BD vendor to provide product education for the clinical nurses and patient care techs.
- D. Lambert worked with the BD vendor to come in and educate on the PureWick™ male external catheter for day shift and night shift clinical nurses and PCTs throughout the hospital. Education included a review of product components, patient inclusion/exclusion criteria, setup, pericare, placement, removal, and maintenance of the product. The BD vendor provided D. Lambert with flyers to post on the unit with dates and times the vendor would be onsite.
- BD vendor Sandra Watson, BSN, RN, CIC, Senior Infection Prevention Manager, provided in-person education on the PureWick™ male external catheter for day shift and night shift clinical nurses and PCTs throughout the hospital by visiting the units March 11 to 13, 2024.
- On March 20, 2024, the Purewick™ male external catheter was delivered and distributed to all patient care units that stock male external catheters. The clinical nurses and PCT were given two weeks to use the product before being surveyed post-intervention.
The interventions were fully implemented by April 2, 2024.
Recognizing an opportunity to address clinical nurse satisfaction, T. Lambert improved the nurse practice environment through communicating with clinical nurses to make a product change of the current male external condom catheters to the BD PureWick™ external male catheter.
References
Khosla, L., Sani, J., & Chughtai, B. (2022). Patient and caretaker satisfaction with the PureWick system. The Canadian Journal of Urology, 29(4), 11216–11223. https://www.canjurol.com/html/free-articles/2022/29-04/Cdn_JU29-I4_08_FREE_ DrKhosla.pdf
Newman, D. (2020). Complications & Adverse Events - External Urinary Catheters.
UroToday. https://www.urotoday.com/library-resources/bladder-health/120650-complications
-adverse-events-external-urinary-catheters.html
Outcome