Catheter09

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Projects
Active?: legacy
Program: Med
Requestor: Kimberly Jabusch
Collection start: 2009-10-29
Collection end: 2010-01-31

Legacy only, see below for details


Data Integrity Checks (SMW)

 AppStatus
Query s tmp apostrophe in commentCCMDB.accdbimplemented





The Nursing Leadership Counsel at St Boniface General Hospital is working on reducing the incidence and duration of urinary catheterizations without appropriate clinical indications for medicine patients at St Boniface General Hospital. We will collect some data for them as part of our temporary studies, initially for three months, but possibly longer pending the results at that time.

Catheter09 Meeting Minutes

Dates

Testing Date

  • Testing period October 1-28, 2009

Start Date

  • Real time start date: All patients who are "discharges" starting October 29, 2009

Review Date

  • Review Date (~75 days after start): 15 Dec 2009

Stop Date

  • January 31,2010 @ midnight'.--TOstryzniuk 20:01, 27 January 2010 (CST)
  • patients that were "admitted" prior to Jan 31.10 midnight, you will continue to follow until they are discharged or transferred to another ward from your ward. Once this occurs, the catheter09 study is done for that patient.--TOstryzniuk 17:27, 1 February 2010 (CST)

Last patient was discharged long ago, disabling this study in CCMDB. Ttenbergen 12:32, 25 February 2011 (CST)

Collection Instructions

Make a record in L_TmpV2 for every indwelling urinary catheter on your ward. It does not matter whether the patient arrived with it or was catheterized locally. 'This data needs to be completed as soon as possible for all patients, not only those who are being sent, since the data is sent for all patients every time data is sent.

In the TMP file, every patient must have TWO lines of entries for every foley catheter incident. We need more data than you can put on one line. We could have recorded a line for each data element, but to speed it up for you we combined them on 2 lines as follows: Under Item:

  1. R-"Reason" from Item dropdown list; cath event #"1"; "Dr. order" on checkbox; in date; in time.
  2. W-"Where inserted" from Item dropdown box; cath event #"1"; "UTI post" checkbox; out date; out time. (may not have a removal date if: died, moved to ICU or moved to another ward with same foley)
  • For example:

*1. Project: Catheter09

*2. Project: Catheter09

If a patient was catheterized more than once, enter several sets of records. Make sure you finish entering one set of records before starting the next, as the record date/time will be used to group the records.

"Reason for insertion" data

Choose the first item starting with an “R-” listed under Catheter09’s item list that applies to this patient. The items are specifically ordered so that if you choose the first one that applies we will get the best results.

Catheter event data (int_var_label)

Catheter event number, i.e. "1" for the first catheterization, "2" for the second

Dr order

Check the checkbox if there is a doctor’s order to catheterize in the chart

in date, in time (insert) / out date, out time (remove)

Date and time the catheter was inserted or removed.

  • Make a reasonable effort to find the right time/date
    • If you can’t find a time, use midnight
      • If the time is in fact midnight, record 23:59
    • If you can't find a date, use your best guess
    • If you can't find a time or date, enter your best approximation given the available data

"Where" Data

Choose the place (elements starting with "W-") where the catheter was inserted.

UTI (urinary track infection)

Check the UTI check box for any patient who acquired a UTI while catheterized.

For the UTI to be considered catheter related, the positive (+ve) urine sample must be taken between >48 hrs after the catheter has been inserted and <=48 hrs after the catheter was removed.

Data Structure Setup

The s_tmp lines driving this will be similar to the following table. These lines need to be added to the s_tmp table on CCMDB.accdb and on the PDA.

Project Value Instructions int_var_label float_var_label bool_var_label date_var_label time_var_label complete_sent
Catheter09 R-arrived with foley (one line per reason see Wiki Catheter09 cath event "#" ~~ Dr order (checkbox marked = Yes) in date in time TRUE
Catheter09 W-(where inserted). One line per option see Wiki Catheter09 cath event "#" ~~ UTI (checkbox marked = Yes) out date out time TRUE


Study (Project) "Catheter09

Value - Actual (R) "reason" for insertion options

Note: Arrived with is at the top because it should be chosen for anyone arriving from off unit. Since the instructions say to use the first item on the list which applies, sorting it to the top will make it the option chosen for all who arrive catheterized.

  • R-arrived with foley
  • R-routine foley change (Nov 9.09)--TOstryzniuk 20:18, 9 November 2009 (CST)
  • R-urinary incontinence
  • R-acute/chronic retention
  • R-accurate urinary output
  • R-Mgt decubitus ulcer (perineal/sacral wounds)
  • R-palliative care
  • R-hemostasis-active bleeding
  • R-ordered by Urologist
  • R-order pre OP/procedure
  • R-monitoring of hematuria
  • R-patient preference
  • R-unknown

Instruction

  • no specific instruction listed on PDA

Catheter event (int_var_label)

  • each foley catheter insertion has 2 lines of information in L_tmp on your PDA. One for insertion the other for removal.
  • an identifier allow collector to group the 2 lines to one event.
  • For example for ONE patient:
    • Reason for insertion of initial catheter would have a cath event #1. The remove of this catheter would also be marked with cath event #1.
    • If another foley is reinserted, then this would be marked as cath event #2. When it is removed, it would also marked as event 2.
  • feel free anyone to reword this example.TOstryzniuk 17:38, 3 June 2009 (CDT)

Value Actual (W) "where" inserted options

  • W-STB ER
  • W-STB ICU
  • W-This Ward
  • W-Other STB ward
  • W-Other Facility
  • W-Not Applicable (do not use this option if admitted from ER). If this item is used you must type reason in comment section. (not rolled out yet)--TOstryzniuk 09:36, 3 November 2009 (CST)

Data Processing

Our statistician will pull the data from the TmpV2_1.mdb file on the regional server. We will provide this data to the requester in the following format:

Serial
Site (we don't need site since this is only for STB)
Location
Catheter Event
(R)Reason
Dr.Order
Date & time Inserted
Date & time Removed
Number of catheter days per ward admission (calculated as difference between Date & Time Removed and Date & Time Inserted)
(W)Where inserted
Post Insertion UTI (urinary tract infection)
  • We will not provide patient identifiers at this time, but if necessary later we can resolve Serial, Site and location to patient identifiers.
  • Summary statistics will be provided: 1)Frequencies for Reasons, PI-UTI, Dr Orders, Where Inserted and 2)descriptive stats (N, mean,median,sum, Std Dev, min, max) for 'Total Catheter Days per patient' defined as the sum of catheter days of all ward admissions of a given patient.

Project Wrap up Comments

  • On behalf of the Medicine Program Nursing Leadership Council, thank you to you and your entire team for their assistance with this project. The preliminary data was shared with the Council last week and this was the baseline data we required to now be able to move on to implementation of the clinical practice guidelines. I have spoken with Julie and she will provide a final report in February 2010. I do not require a final meeting. Again, thanks much. Regards,
  • Kimberly Jabusch, RN MN BA
  • Clinical Nurse Specialist
  • St. Boniface General Hospital
  • Medicine Program

Data Integrity Checks (SMW)

 AppStatus
Query s tmp apostrophe in commentCCMDB.accdbimplemented