De-Implementation of Urinary Catheters in Neurosurgical Patients during the Operation and on the Ward: A Mixed-Methods Multicentre Study Protocol

Author(s): Jeanne-Marie Nollen RN, MSc, Anja H Brunsveld-Reinders RN, PhD, MSc, Wilco C Peul MD, PhD, MPH, MBA, Wouter R Van Furth MD, PhD


Indwelling urinary catheters (IDUCS) are routinely inserted during transsphenoidal pituitary gland tumour surgery or spinal fusion surgery, despite literature stating that there are no indications for using IDUCS during or following these surgeries. The aim of the study is to reduce the number of inappropriately inserted IDUCS during or post transsphenoidal pituitary gland tumour surgery and spinal fusion surgery with an operation time of less than 4 hours.


A pragmatic, before-and-after mixed-methods observational study was initiated in a multicentre neurosurgical context. This study includes medical chart analysis, satisfaction surveys with patients and healthcare professionals, and multidisciplinary group interviews to assess the effectiveness of, and experiences with, a multifaceted non-invasive de-implementation strategies The study has a timespan of 2.5 years starting in 2020.


This paper presents the study protocol of a multi-centred before and after trial that aims to reduce inappropriate IDUC use after transsphenoidal pituitary gland tumour surgery and spinal fusion surgery, thereby reducing UTIs, shortening length of hospital stay, and increasing patient comfort. The results can be used to de-implement IDUCS after a broad range of surgeries on several wards.

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