Ms NELLIE TUMU1
1Port Moresby National Referral Hospital, Papua New Guinea
Biography:
Experienced and highly qualified Registered Nurse with over 20 years’ diverse clinical experience across Australia, New Zealand, and Papua New Guinea. Skilled & qualified infection control preventionist, field epidemiologist, and nursing. Holds a Master of Nursing (Monash University, Victoria) and multiple professional certifications. development in healthcare settings. Passionate about IPC
Abstract:
Objective
To evaluate a Multi-Modal Intervention (MMI) package aimed at reducing unnecessary urinary catheterization and utilization rates in Internal Medicine Ward (IMW) 1D at PMNRSTRH.
Design
A pre- and post-implementation quality improvement study incorporating baseline assessments, follow-up point prevalence surveys, and sustainability analysis.
Setting
IMW 1D, a 22-bed general medical unit at PMNRSTRH managing infectious and non-communicable diseases. The ward previously lacked standardized catheter protocols.
Participants
Adult patients admitted to IMW 1D with indwelling urinary catheters.
Methods
The study followed three stages: pre-baseline, post-implementation, and sustainability. Interventions included healthcare worker education, evidence-based guideline introduction, and mandatory daily reviews of catheter necessity. Primary outcomes were the appropriateness of catheter indications and the catheter utilization ratio.
Results
At pre-baseline, 45% of catheters were appropriately indicated with a 57% utilization rate. Post-implementation, appropriate indications rose to 52%, while utilization remained steady at 58%. During the sustainability phase, appropriateness further improved to 64%, and the utilization rate significantly decreased to 45%.
Conclusion
The MMI successfully enhanced the clinical appropriateness of urinary catheter use and reduced overall utilization in a resource-limited setting. Results suggest that evidence-based protocols and daily reviews are effective, provided they are supported by continuous education to maintain long-term improvements in patient safety and clinical practice.