Authors: (including presenting author): :
Chan KY (1), Chan MY (1), Wong CH (1)
Affiliation: :
(1) Accident and Emergency Department, Tseung Kwan O Hospital
Keyword 1: :
Nurse-initiated Intervention
Keyword 3: :
Emergency Nursing
Introduction: :
Acute Retention of Urine (AROU) is a common urological emergency in emergency departments. Given the growing number of patients with critical, emergency and urgent conditions (i.e. triage category 1-3), time to complete treatment is expected to increase, a nurse-initiated protocol has been introduced since June 2025 to meet this service gap. This protocol is proposed by KY Chan, CH Wong and Dr. MY Chan. Briefing session for this protocol was done to all nurses and doctors in May 2025. 64 nurses have completed an online assessment about the understanding of this protocol. Under the new protocol, nurse can initiate foley catheterization for patient with AROU or change foley catheter for patient requiring long term foley catheter with blockage before medical consultation accordingly.
Objectives: :
To reduce the time between triage and the completion of Foley catheter insertion or Foley catheter change. To relieve the distressing symptoms of patient with acute retention of urine (AROU) or foley blockage.
Methodology: :
PDSA (Plan-Do-Study-Act) cycle is used to guide the implementation. During the planning phase, this protocol was reviewed and endorsed by department management team. Protocol briefing to nurses and doctors were completed in “Do” phase. Nurses’ knowledge about this protocol was assessed via online assessment. Data analysis was performed before and after the implementation of protocol in “Study” phase. Review and modification of this protocol will be done in "Act" phase.
Result & Outcome: :
The CQI project was launched on 9 June 2025. There were 211 patients recruited in this protocol, including 191 males and 20 females by the end of December 2025. The median age of these patients is 74-year-old. The average time between triage to completion of foley insertion has reduced from 48.5 minutes (Jan to May 2025) to 23.4 minutes after the implementation of this project. The time between triage and foley catheterization is successfully shortened by 50%. No adverse event was reported.
