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A pilot study took place first in a 20 bed ICU and then in a 42 bed women's oncology unit and took place over 1 month. Prior to the start of the pilot, the team went to these units and provided education to the staff on the study and how to properly apply these devices for the intended use. The nurses were also educated on the contraindications for the external catheter such as recent vaginal surgery, urinary retention, bowel incontience, etc. The use of the external catheters also did not require a physician's order so it was to the nurses discretion who they placed them on. After the pilot study, patients were expressing their positive opinions of the product and then the product was put into place in 2018, but in order to get accurate results from the study, data was not collected until 2019 in order to give the nurses time to get comfortable with using the product.

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Tran, Christine MS, RN, OCN, AGCNS-BC; Rodrigue, Debra MA, RN-BC, AOCNS; Jones, Tasina MSN, RN-BC, CNS, AOCNS; Bell, Natalie MSN, RN. (2023). Addressing CAUTIs with an External Female Catheter. AJN, American Journal of Nursing, 123(1), 50-55, https://doi.org/10.1097/01.NAJ.0000911540.75111.b4

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Tran, Christine MS, RN, OCN, AGCNS-BC; Rodrigue, Debra MA, RN-BC, AOCNS; Jones, Tasina MSN, RN-BC, CNS, AOCNS; Bell, Natalie MSN, RN. (2023). Addressing CAUTIs with an External Female Catheter. AJN, American Journal of Nursing, 123(1), 50-55,  https://doi.org/10.1097/01.NAJ.0000911540.75111.b4

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P: The plan for the study was decrease the amount of CAUTIs in female patients.

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D: To reduce the amount of CAUTIs, a team of nurses came up with the idea to use external catheters to reduce the infection rate, but still be able to get accurate urine outputs on patients.

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S: During the study, the data showed that with the use of external catheters, that not only did the number of CAUTIs decrease, but the amount of money that hospitals were spending towards CAUTIs also decreased.

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After the start of using external catheters, the rate of CAUTIs began steadily decreasing. The group only noticed a rise in CAUTI rates in 2019 and this is believed to have been due to the external catheters being on back order. The use of the external catheters also benefited the organizations they were being used in by saving them a great deal of money.

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The effectiveness of the study was evaluated by looking at the number of CAUTIs on females who were bedbound compared to before the external product was launched. The cost effectiveness of this study was also evaluated and in 2019 and 2020 combined the external catheters were used on 1,195 female patients and with the total cost of treating a CAUTI, the use of the external catheters avoided over 16 million dollars in cost of treating the patients who could have developed CAUTIs.

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The issue at hand is the increased risk for catheter associated urinary tract infections in women. The nurses who published this article are conducting research on alternatives methods of a catheter that allow the female patients to remain dry to prevent skin breakdown but also lower the number of patients catheterized in order to prevent UTIs.

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Opposed to males who have the option for a condom catheter which is non-invasive and does not introduce bacteria that can cause a UTI to the urinary tract, the only option for female catheterization is to have the catheter inserted into the urethra leading to the bladder. In the past, this has been the only option for patients who need to have an accurate urine output documented. The use of briefs for incontinent patients doesn't allow the nurse to have an accurate output, but with the use of external catheters for women, the nurse can have an accurate urine output while also not introducing bacteria into the urinary tract.

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A: The nurses who wrote this article recommended the use of external female catheters to not only prevent CAUTIs in female patients, but were also saving the organizations using them money along the way.

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Inserting a indwelling catheter can lead to a CAUTI, which can cost about $13,813, opposed to placing an external catheter on a female and the patient not developing an infection is only $27. Therefore, not only is using external catheters better for the patient, it also saves the hospitals money. The risk for a CAUTI goes up by about 5% everyday that the catheter is left in place. This mean by day 20 that the patient has a 100% chance of developing a CAUTI.

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This study is needed to avoid as many CAUTIs as possible to provide the best care possible to patients, without causing additional infections during their stay in the hospital.

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In healthcare, 30% of the infections acquired are UTIs and a majority of them are associated with the use of indwelling catheters.  When this study was conducted, the nurses looked at the amount of times that an external catheter was used in place of a physicians recommendation for a indwelling catheter and in 90% of cases an external catheter was used in place of an indwelling catheter.