Implementation of an external female urinary catheter strategy on prevention of skin breakdown in acute care: A quality improvement study

Aim(s) To evaluate the incidence of skin‐related complications attributable to incontinence‐associated dermatitis (IAD) using an external female urinary catheter device strategy for urinary incontinent (UI) patients in acute care. Design Multicenter quality improvement study. Methods Randomized allocation of two commercially available external female urinary catheter devices was used in hospitalized UI female patients. Daily nursing skin assessments were documented in the electronic health record before, during and after external catheter device application. Methods and results were reported following SQUIRE guidelines. Results Three hundred and eighty‐one patients from 57 inpatient care units were included in the analysis. Both catheter devices were associated with an overall low risk (5 %) of new or worsening skin breakdown. Conclusion The overall benefit of external catheters is most persuasive for skin integrity, rather than infection prevention. Impact Significant negative outcomes are associated with UI patients. External female urinary catheters are a non‐invasive alternative strategy to reduce exposure of regional skin to urine contamination and IAD‐related skin complications. Use of external female urinary catheters in hospitalized UI female patients offers low risk (5%) of new or worsening overall skin breakdown. Patient Contribution Hospitalized UI female patients were screened for external catheter device eligibility by the bedside nurse. The quality improvement review committee waved consent because the intervention was considered standard care.