Improving Charting Accuracy of External Urinary Collection Devices

Session Description: External urinary collection devices (EUCDs), offer a non-invasive alternative to indwelling catheters and are effective in reducing catheter-associated urinary tract infections (CAUTIs). There is limited literature addressing documentation for EUCDs. This quality improvement project at a large acute care teaching facility & trauma center, aimed to assess completeness of documentation records, guide educational improvement and gauge alignment with best practices.
Using a point-prevalence design, volunteers audited 362 adult inpatients with EUCDs. Devices included suction- and gravity-based models. Team members were required to identify device type, output recording, prior Foley catheter (FC) history, and documentation completeness in the electronic health record. (EHR) avatar. Volunteers who participated were staff and were using this data collection as part of a clinical ladder project. Infection Prevention trained volunteers in standardized data collection tool.
Documentation was complete in 28% (n=101) of cases. Common omissions included device type, placement date, and responsible clinician. Output was recorded in 67% of charts, but FC history was documented in only 38%. Documentation compliance did not differ significantly by gender or device type. These findings mirror national concerns regarding underutilization of EHRs to track EUCDs and ensure surveillance fidelity.
Despite increasing use of EUCDs to mitigate CAUTI risk, documentation practices are critically inadequate. System-wide interventions including staff education, EHR template standardization, and accountability measures are essential to improve patient safety and support infection surveillance.
Future goals for this project include a repeat of the point- prevalence study to capture improvements in documentation and prolonged sustainability. Prior to repeating the study, a focus of re-education to frontline staff who place and document EUCD’s will be conducted. This education will reiterate the importance of proper documentation of EUCD’s in the EHR to better capture their utilization.

Kelly D'Aries

Infection Preventionist, Morristown Medical Center

Kelly D’Aries, MSN, RN, MEDSURG- BC, CIC. Is an Infection preventionist with experience in the acute care setting. Her roles have included care of patients with complex pulmonary conditions. After battling COVID on the front lines during the COVID pandemic she pursued a role in epidemiology. Currently certified in Medical/Surgical nursing as well as having her CIC, and she also obtained her MSN in Nursing Administration at Ramapo College. She also serves on the nominating committee for the Northern New Jersey APIC Chapter.

Gina Behnke

Infection Prevention RN, Atlantic Health System

Gina Behnke, BSN, RN, CIC is an Infection preventionist with experience in the acute care setting. Her roles have included care of patients with complex cardiac conditions. After battling COVID-19 on the front lines during the pandemic, she pursued a role in epidemiology. She is currently CIC certified and has been in Infection Prevention for over five years. She is currently working toward earning her Master's degree in Nursing Administration. She also serves on the Northern New Jersey APIC board as Webmaster/ Corresponding Secretary.

Kimberly Daniels

Infection Control Practitioner, Kindred Hospital Louisville

Kimberly Daniels is a board-certified Infection Preventionist at Kindred Hospital in Louisville, Kentucky. With over 20 years of healthcare experience, Kimberly has fulfilled a variety of nursing and administrative roles within the long-term acute care setting. Kimberly served as an Infection Prevention Collaborative Nurse with the Kentucky Department for Public Health, where she had the pleasure of providing guidance in the control and prevention of healthcare-associated infection transmission throughout the state. Kimberly has taken part at a leadership level on several multidrug-resistant organism outbreak investigations both at the state and local facility levels. Kimberly is a member of the National Association for Professionals in Infection Control and Epidemiology (APIC) and served as the President of the local Kentuckiana APIC chapter in 2020 and 2021. Kimberly strives to use her various nursing experiences and her knowledge of Infection Prevention to promote patient safety and to enhance patient-related outcomes.