Document Type

Final Project

Graduation Date

Spring 5-10-2025

Degree Name

Doctor of Nursing Practice

First Advisor

Trina Aguirre

Abstract

Aims and Objectives- 1: Describe and measure current implementation and management practices of the PureWick™. 2: Describe and measure current outcomes in the use of the PureWick™ device including mobility scores, skin breakdown, Braden scores, moisture-associated dermatitis, CAUTIs, PAUTIs, hospital LOS, HAIs and HPIs. 3: Measure the survey results from staff regarding the current PureWick™ practices. 4: Propose recommendations for an improved EB protocol for the PureWickTM.

Background: Currently, the PureWickTM device has been utilized by facilities as an alternative to indwelling urinary catheters in an effort to reduce the incidence of CAUTI. Since the introduction of the device, there have been over 500 adverse events reported to the FDA.

Design: This QI project was implemented using the Iowa Model.

Methods-This project used a retrospective chart review (n=65) for data collection related to the use, management, and outcomes associated with the use of the PureWickTM device. In addition, staff surveys (n=59) were utilized to identify current perceptions, education deficits, and beliefs about the PureWickTM device.

Results-HAPIs occurred in 22% of the studied patient population that used the device. Those patients that utilized the device and developed a HAPI had a statistically significant longer hospital stay. Patients that were considered mobile used the device almost as frequently as less mobile patients. 47% of staff surveyed reported that they feel that the PureWickTM device limits a patient’s mobility. 39% of staff members reported inadequate training on the device. 74% of charts were deficient in documentation pertaining to the device’s level of suction at any point during its use.

Conclusions- A device that has been correlated to adverse patient outcomes in the literature review, FDA reporting, and through the results of the data collection from this QI project; warrants a proposal to seek best practices to prevent morbidity and mortality in the hospitalized, female patient with urinary incontinence.

Relevance to clinical practice-In an era in which we seek to provide the best care, protocols to ensure the safety of the patient must be implemented. Each facility should work to develop an evidence-based protocol for the PureWickTM that aims to prevent a decline in baseline mobility.

No Patient or Public Contribution- aside from patient chart reviews, no patients or public contributed to this project.

What does this paper contribute to the wider global clinical community?

The findings of this QI project should:

· Create an awareness that this device, although appearing non-invasive, can result in patient injury when implemented and managed inappropriately.

· Encourage future study of the device related to mobility. If the device is not utilized appropriately this device may contribute to a decline in baseline mobility. These outcomes should be studied on a larger population.

· Highlight the importance of investigating the PureWickTM device on a larger scale to develop evidence-based recommendations for the implementation and management of the UI device in the hospitalized, female patient.

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