240 - Precision in Practice: Ultrasound-Guided Bladder Scanning and Catheter Placement Confirmation in a Community Hospital Setting

Objectives: Inaccuracies in post-void residual (PVR) measurements and urinary catheter placements can lead to patient discomfort, infection, and additional complications. This quality improvement (QI) project aimed to enhance the accuracy of PVR measurement and urinary catheter placement confirmation in the Emergency Department (ED) at St. Joseph’s Medical Center (SJMC) through ultrasound-guided bladder scanning. By implementing a targeted training program, we sought to improve registered nurses’ (RNs) proficiency and confidence in using point-of-care ultrasound (POCUS) for these tasks, with a goal of a 20% improvement in PVR measurement accuracy and a 20% reduction in incorrect catheter placements within six months.

Design: This project was structured as a pre- and post-intervention QI initiative. Baseline data on the accuracy of PVR measurements and incidents of incorrect catheter placement were collected over three months prior to intervention. A cohort of ED RNs received an 8-hour comprehensive training session on ultrasound-guided bladder scanning techniques, facilitated by ultrasound-trained clinicians. Key components included hands-on POCUS practice and standardized protocols for PVR assessment and catheter placement verification. Post-intervention data collection mirrored baseline data, assessing changes in PVR accuracy, catheter placement errors, and RN confidence in POCUS use through surveys and clinical audits.

Results: Currently in the implementation stage - Results pending. Should be ready prior to the AAP 2025 Annual Meeting

Conclusions: This QI initiative should demonstrate that targeted ultrasound training can significantly improve PVR measurement accuracy and catheter placement confirmation, enhancing both patient safety and care quality in a community hospital setting. Sustaining these improvements through ongoing training and establishing a protocol for routine POCUS use in catheterization could further reduce complications and support continuous learning. Future studies may explore expansion into other departments to assess broader impacts of ultrasound-guided procedures on patient outcomes across various clinical settings.