TY - JOUR T1 - Interventions to reduce urinary catheter use: it worked for them, but will it work for us? JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 967 LP - 971 DO - 10.1136/bmjqs-2013-002331 VL - 22 IS - 12 AU - Jennifer Meddings Y1 - 2013/12/01 UR - http://qualitysafety.bmj.com/content/22/12/967.abstract N2 - In most hospitals, four steps are required to remove a urinary catheter1: the physician recognises the patient has a catheter in place; the physician realises the catheter is no longer necessary; the order is written to remove the catheter; and the nurse removes the catheter. Interventions to prompt removal of unnecessary urinary catheters by expediting these steps are primarily of two types1: ‘reminders’ which function to simply remind that a urinary catheter is in place and should be removed if unnecessary2–5 and ‘stop orders’ which prompt nurses or physicians to remove catheters based on criteria, such as 24–48 h after surgery6 ,7 or when the patient no longer meets other clinical criteria.8–12 These interventions can be implemented using a range of technology, as complex as a computer-generated reminder or stop order8 ,13–15 initiated with each catheter order, or as simple as printed post-procedure order sets6 ,7 with stop orders, sticker reminders on charts2 ,4 or catheter bags,16 a mandatory daily verbal3 reminder from nurses to physicians of catheterised patients, or as a reminder on a checklist6 ,17 ,18 used daily on rounds. These interventions can be directed at either physicians4 ,13 ,14 or nurses, with nurse-directed interventions ranging from requiring nurses to remind physicians to order catheter removal6 ,17–20 to nurse-empowered stop orders9–12 ,21 ,22 enabling nurses to remove catheters that do not meet appropriate criteria, without requiring an additional physician order. Consequently, there are many options to consider when designing an intervention to facilitate removal of unnecessary catheters, with success demonstrated using all of these options.The article by Janzen et al23 in this issue of the journal describes an intervention aimed … ER -