Soarian Urinary Catheter Workflow

1. Soarian Urinary Catheter Workflow Purpose: To reduce the risk of infection from prolonged urinary catheter placement

2. Facts: Foley Catheter UTI • In 2008, PinnacleHealth had 97 symptomatic UTI infections. • 80 of those patients met the criteria for a Foley Catheter-associated UTI. • The average Foley Catheter UTI increases a patient’s medical cost by $1000-$1500 if uncomplicated by sepsis. • CMS will not reimburse for additional costs related to the care of a Foley Catheter-associated UTI.

3. Urinary Catheter (Foley) Workflow A workflow has been created in Soarian to generate an ALERT to the Physician’s worklist daily at 0600 AM, if a urinary catheter has been inserted. The alert will include 2 suggested actions: you can link to discontinue the Foley or link to maintain it. If keeping the catheter, you must document a reason for continuation on the Foley Evaluation Form every 24 hours until D/C’d. *Note: If the reason documented is palliative care/terminally ill, the workflow stops. The workflow will also stop once the order is discontinued- in both cases, no further Alerts will be posted.

4. View from the Patient Census View from the Clinical Summary If your patient has an order for a urinary catheter, an Alert will be posted at 06:00AM every morning. This Alert can be viewed from the Census Page or the Clinical Summary.

5. Census Page View Clinical Summary View If viewing from the Census page, click on the arrow to the left of Alerts to view the Alert information.

6. To D/C the urinary catheter, click on the arrow the right of the discontinue message 1. Click on the top arrow to D/C the urinary catheter 2. Clicking the “Yes” button will evoke an auto discontinue order. A notice is then sent to the nurse to remove the catheter. You must select decide whether to keep the Foley or to Discontinue it.

7. Maintaining the Foley View from the Patient Census View from the Clinical Summary If you elect to keep the urinary catheter order, you must click on the arrow to the right of the reason for continuation message. You will be taken to a form to document a reason for maintaining the catheter.

8. Click here to sign the assessment A Foley Evaluation Assessment screen appears. Place a check mark by the appropriate reason (multiple reasons can be selected) and sign the assessment. This will then remove the alert, however it will reappear tomorrow at 06:00AM and will continue to require documentation daily until the urinary catheter is discontinued.

9. Note: If the reason selected is TerminallyIll/Palliative Care, once signed, the workflow stops.