Observational studyBMJ open quality2025
Improving postoperative care for neurosurgical patients by a standardised protocol for urinary catheter placement: a multicentre before-and-after implementation study.
Observational study in BMJ open quality, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Machine learning prediction of postoperative pulmonary infection in patients who underwent thoracoscopic lung cancer resection: a retrospective case-control study.BMC medical informatics and decision making · 2026Article
- Clinical needs assessment for non-invasive intraoperative bladder volume monitoring devices: a cross-sectional study based on the Kano model.Scientific reports · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionUrinary catheterisation, including indwelling and clean intermittent catheterisation, is common in perioperative and postoperative care. Despite guidelines, practice variation is significant. Inappropriate catheterisation risks include urinary tract infections and reduced mobility, leading to prolonged hospital stays and increased antibiotic use. This study aims to improve postoperative care through appropriate catheterisation in neurosurgical groups frequently subjected to catheterisation.
methodsWe conducted a multicentre, before-and-after study in four Dutch hospitals from June 2021 to January 2023, including adult neurosurgical patients who underwent pituitary gland tumour or spinal fusion surgery. Exclusion criteria included conditions requiring chronic catheter use. A multifaceted strategy was implemented, focusing on a uniform protocol, an educational programme and department-specific champions. The primary outcome was inappropriate catheterisation, analysed with ordinal logistic regression. Secondary outcomes included total catheterisations, urinary tract infections and length of hospital stay. Ethical approval was obtained. Strengthening the Reporting of Observational Studies in Epidemiology and SQUIRE checklists were used.
resultsAmong 3439 patients screened, 2711 were included, with 544 in the after group. The percentage of patients without inappropriate indwelling catheterisation increased from 46% to 57%, and the proportion without inappropriate clean intermittent catheterisation rose from 34% to 67%. Additionally, overall catheter use decreased: the percentage of patients not receiving an indwelling catheter increased from 54% to 64%, while those not requiring clean intermittent catheterisation rose from 89% to 92%. Infection rates and hospital stay were similar (1.4% and 1.3%; 4.9 and 5.1 days, respectively).
conclusionsImplementing a uniform protocol may significantly reduce inappropriate and overall catheterisation in neurosurgical patients, aligning with patient-centred, less invasive healthcare. Ongoing education and adherence to standardised protocols are crucial. Future research should assess the long-term sustainability of these strategies.
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