OUTCOMES OF A QUALITY IMPROVEMENT INTERVENTION TO REDUCE UNNECESSARY URINARY CATHETER UTILIZATION
Bibliographic record
Abstract
Urinary catheters are often placed unnecessarily, exposing patients to complications including urinary tract infections, falls, deconditioning, pressure ulcers and death. As older adults are at particular risk of these sequelae, we introduced a multi-modal intervention incorporating educational posters, small group teaching sessions, and changes to the hospital’s computer physician order entry and nursing documentation systems to encourage evidence-based utilization of urinary catheters. A total of 24,499 patient admissions were included during the overall 41month study period. A quasi-experimental interrupted time series study was designed using segmented regression to assess outcome indicators. Across the services under study, mean catheter days per patient decreased by between 5.6 and 10.0 days (p < 0.01), while the absolute incidence of urinary catheterization almost halved across the same cohort (p < 0.01) following the intervention. The results from this study suggest that a relatively simple bundle of interventions can result in dramatic health outcome improvements.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".