Introduction
Urinary catheters are commonly used in hospital settings among postoperative patients. Mastery of urinary catheter placement and management is a fundamental skill for all surgical interns. Despite this, interns often lack experience and training, leading to difficulty in addressing common catheter-related complications such as meatal pain, bladder spasms, and hematuria. We aimed to develop and evaluate the efficacy of a catheter education curriculum geared toward incoming surgical interns, focusing on troubleshooting catheter placement and managing associated discomfort.
Methods
We designed a catheter education course which was delivered as a part of the surgery intern bootcamp. The curriculum covered urethral anatomy, catheter types and indications, management of urinary retention, troubleshooting difficult placements and non-draining catheters, and managing catheter discomfort. Pre- and post-curriculum surveys assessed comfort levels with various aspects of catheter management on a Likert scale. Urology consultation data for catheter issues from pre and post curriculum were abstracted to evaluate longitudinal efficacy. Paired t-tests were conducted to analyze changes in pre- and post-curricular outcomes. Significance set at p<0.05.
Results
Out of 37 surgical interns, 16 responded to the surveys (43.2%). Prior to the curriculum, only 25% of non-urology residents had placed more than 5 catheters, and none had placed more than 10. Post-curriculum, significant improvements were observed in residents' confidence in placing routine catheters (mean increase from 3.17 to 4.00), familiarity with male urethral anatomy (mean increase from 3.0 to 4.0), and managing catheter discomfort (mean increase from 2.00 to 3.00) among non-urology residents. The majority (75%) of respondents indicated that catheter management education would be a valuable addition to the surgical intern curriculum. Additionally, catheter consults to urology significantly decreased from 128 to 80 in the academic year following the curriculum.
Conclusion
The introduction of a targeted catheter education curriculum significantly improved surgical interns' confidence and competence in managing catheter-related issues. Additionally, difficult catheter and catheter discomfort consults decreased, suggesting long-term efficacy of the curriculum. These results highlight the importance of focused training in reducing uncertainty and potential complications associated with catheters, ultimately leading to better patient care.
References
ACS/APDS Surgery Resident Skills Curriculum - Phase 1. Published online February 15, 2017. Accessed August 12, 2024. https://learning.facs.org/content/acsapds-surgery-resident-skills-curriculum-phase-1
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