The surgery clerkship: an opportunity for preclinical credentialing in urinary catheterization

Am J Surg. 2012 Oct;204(4):535-9. doi: 10.1016/j.amjsurg.2012.01.015. Epub 2012 May 15.

Abstract

Background: At our hospital, medical students lost privileges to perform urinary catheterization because of concern regarding catheter-associated urinary tract infections. We hypothesized that trained medical students could perform urinary catheterization with the same proficiency as licensed practitioners.

Methods: Medical students completed a credentialing program in urinary catheterization. Prospectively, the rate of catheter-associated urinary tract infections after urinary catheterization performed by medical students was compared with the health system-wide rate of catheter-associated urinary tract infections after urinary catheterization performed by non-medical students using an incidence rate ratio (IRR).

Results: Over 9 months, a total of 432 and 55,401 catheter days accrued in patients who underwent urinary catheterization by medial students and non-medical students, resulting in 1 and 129 catheter-associated urinary tract infections, respectively. The incidence rate of catheter-associated urinary tract infections per 1,000 catheter days was 2.31 in the medical student-placed catheters and 2.33 in the non-MS-placed catheters (IRR = .99, P = .55).

Conclusions: Preclinical credentialing in urinary catheterization resulted in the reinstatement of urinary catheterization privileges to qualified medical students. Student proficiency in urinary catheterization can match that of licensed practitioners.

MeSH terms

  • Adult
  • Certification*
  • Clinical Clerkship*
  • Clinical Competence*
  • Female
  • General Surgery / education*
  • Humans
  • Incidence
  • Male
  • Odds Ratio
  • Philadelphia / epidemiology
  • Urinary Catheterization* / adverse effects
  • Urinary Catheterization* / methods
  • Urinary Catheterization* / standards
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / etiology*