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The effect of resident peer-to-peer education on compliance with urinary catheter placement indications in the emergency department
  1. Nicholas G Dyc1,2,
  2. Margarita E Pena1,2,
  3. Stephen P Shemes3,
  4. Janice E Rey4,
  5. Susan M Szpunar3,
  6. Mohamad G Fakih4,5
  1. 1Department of Emergency Medicine, St. John Hospital and Medical Center, Detroit, Michigan, USA
  2. 2Wayne State University School of Medicine, Detroit, Michigan, USA
  3. 3Department of Medical Education, St. John Hospital and Medical Center, Detroit, Michigan, USA
  4. 4Department of Infection Control, St. John Hospital and Medical Center, Detroit, Michigan, USA
  5. 5Division of Infectious Diseases, Department of Medicine, St. John Hospital and Medical Center, Detroit, Michigan, USA
  1. Correspondence to Dr Margarita E Pena, Department of Emergency Medicine, St. John Hospital and Medical Center, 22101 Moross Road, Detroit, MI 48236, USA; margarita.pena{at}stjohn.org

Abstract

Objective This study aims to evaluate the effect of resident peer-to-peer education on knowledge of appropriate urinary catheter (UC) placement in the emergency department (ED) and to determine if this translates into further reduction in UC utilisation.

Background Instituting guidelines for appropriate UC placement reduces UC utilisation in the ED. No study has explored if resident education in a teaching hospital would further reduce UC utilisation.

Methods An educational intervention implemented in February 2009 consisted of a lecture, distribution of pocket cards and a peer-administered weekly review of institutional UC guidelines. A 12-question multiple-choice test was given to residents prelecture and postlecture, and the 12-question test was repeated 3 months later. Retrospective chart review was performed to evaluate UC utilisation before, immediately after and 3 months after the educational intervention.

Results 30 residents completed all three tests. Significant differences were found between the mean test score pre-education and the mean test score immediately after education (9.43±1.17 vs 10.87±1.46, p<0.001) and between the mean test score pre-education and the mean test score 3 months posteducation (9.43±1.17 vs 10.43±1.28, p<0.001). There was no significant difference in UC utilisation or in the proportion of indicated UCs placed by residents within the three study periods.

Conclusions Resident peer-to-peer education was associated with improvement of knowledge but did not result in decreased UC utilisation. A more active approach must be taken and other factors need to be further explored to reduce unnecessary placement of UC by residents in the ED.

  • Education
  • urogenital
  • infection
  • guidelines
  • emergency department
  • accident and emergency medicine

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Footnotes

  • Funding We are grateful for the financial support provided by Blue Cross Blue Shield of Michigan Foundation Grant 1270ii. The grant was used in data collection performed by SPS, who also assisted in the analysis and interpretation of the data and in the writing of the report. It was also used as salary support (<5%) for MGF, who was involved in study design, data collection, analysis and interpretation of the data, writing of the report and decision to submit the study for publication.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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