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Research Letter
Less Is More
January 2016

Medical Directive for Urinary Catheter Removal by Nurses on General Medical Wards

Author Affiliations
  • 1Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • 2Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • 3Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 4Centre for Quality Improvement and Patient Safety, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 5Department of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • 6Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada
JAMA Intern Med. 2016;176(1):113-115. doi:10.1001/jamainternmed.2015.6319

Leaving a urinary catheter (UC) in place without indication has been identified as one of “Five Things Physicians and Patients Should Question” by the Society of Hospital Medicine and the Canadian Society of Internal Medicine.1,2 On a busy general medical (GM) ward, delays in reassessment of UCs can lead to catheter-associated urinary tract infection (CAUTI).3 Interventions aimed at physicians reduce unnecessary UC use,4 but empowering nurses to remove UCs through the use of medical directives remains an underused strategy.5

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