POUR Timeline
August 2013
8/27 Initial drafts for voiding algorithm and physician order for “patient voiding prior to discharge instructions” completed.
September 2013
AIP PACU nurses took pretest on POUR concepts.
October 2013
10/2 Voiding algorithm completed based on an extensive literature review.
10/8 Phase II committee met to finalize physician order for “patient voiding prior to discharge instructions”
10/17 Department heads and general surgeons emailed for feedback and approval of new order and algorithm to prevent POUR.
10/21 Via PowerPoint presentation, PACU nurses educated at staff meeting on standard definition of POUR, prevention, risk factors, how to use the algorithm, and the new order.
10/23 Patient Service Clerk (Lauren Morrisette) and I found an unused file cabinet, filled it with urinals and hats, and moved it to the Phase II bathroom.
10/24 Bladder scanner relocated to the Phase II area. Algorithm and POUR PowerPoint placed on AIP PACU sharedrive.
November 2013
11/18 Epic Order Set Coordinator (Joann Young) contacted to enter new order.
11/25 Posters delineating POUR pretest results and initial knowledge gap hung in PACU. Nurses read results, reeducated themselves on POUR and associated risks factors, and completed remediation questions to verify knowledge.
January 2014
Approved draft of new order set addendum for “patient voiding prior to discharge instructions” from Epic team.
February 2014
Order addendum to Post Anesthesia Care Unit Discharge instructions moved to production.
Emailed Danielle Schloffman (Magnet Program Director) POUR project results as Magnet submission for structural empowerment.
2/23 Facilitated journal club on POUR management
2/26 Presented POUR interventions to Clinical Quality and Risk Management Committee based on a urinary retention case that occurred in May 2013.
New Epic order for “voiding prior to discharge instructions” available for use.
March 2014
Chart audits conducted to assess use of voiding algorithm and new order.
AIP PACU nurses educated on order set addendum
3/3 Presented POUR PowerPoint, voiding algorithm, and new order at AOP Staff Meeting
3/27 Presented POUR PowerPoint, voiding algorithm, and new order to Perianesthesia Quality Improvement Council.
3/31 Emailed Ashley Walsh for template to write guideline utilizing POUR algorithm
April 2014
Chart audits conducted to assess use of voiding algorithm and new order.
4/1 Emailed GI, IR, and Pre/Post with POUR information and to gauge interest in implementing algorithm
4/17 Emailed Infection Prevention representative (Beth Carrier) the POUR algorithm as a reference for preventing postoperative urinary retention after discontinuing a Foley catheter
4/21 Emailed IR Educator (Gabrielle Shamsabadi) about implementing POUR. She discussed with IR RNs and will loosely implement the algorithm in recovery. (4/21)
4/29 Emailed Joanne Becker to get approval of 2 Unit Based Guidelines:
1. University of Colorado Hospital Guideline: Voiding Algorithm for Preventing Postoperative Urinary Retention
2. Updated: University of Colorado Hospital Guideline for Bladder Scan Use in Post Anesthesia Care Unit
May 2014
Communicated with Joanne Becker to organize Perioperative Guideline Taskforce meeting in order to approve the Voiding Algorithm for Preventing Postoperative Urinary Retention and updates to the Bladder Scan Use in Post Anesthesia Care Unit Guideline.
June 2014
Chart audits conducted to assess use of voiding algorithm and new order.
6/3 PACU Permanent Charge Nurse, Mary Hurlbert, voiced concerns that some PACU nurses are taking the guideline to literally and requiring most outpatients to void prior to discharge.
6/5 Wrote addendums to the Voiding Algorithm for Preventing Postoperative Urinary Retention guideline to clarify that every patient with risk factors does not have to void.
6/5-6/7 Received approval of guideline by the Perianesthesia Quality and Patient Safety Council.
6/10 Presented the Voiding Algorithm and Updated Bladder Scan Use Guidelines to the Perioperative Guideline Task Force.
6/11 Guidelines approved.
8/27 Initial drafts for voiding algorithm and physician order for “patient voiding prior to discharge instructions” completed.
September 2013
AIP PACU nurses took pretest on POUR concepts.
October 2013
10/2 Voiding algorithm completed based on an extensive literature review.
10/8 Phase II committee met to finalize physician order for “patient voiding prior to discharge instructions”
10/17 Department heads and general surgeons emailed for feedback and approval of new order and algorithm to prevent POUR.
10/21 Via PowerPoint presentation, PACU nurses educated at staff meeting on standard definition of POUR, prevention, risk factors, how to use the algorithm, and the new order.
10/23 Patient Service Clerk (Lauren Morrisette) and I found an unused file cabinet, filled it with urinals and hats, and moved it to the Phase II bathroom.
10/24 Bladder scanner relocated to the Phase II area. Algorithm and POUR PowerPoint placed on AIP PACU sharedrive.
November 2013
11/18 Epic Order Set Coordinator (Joann Young) contacted to enter new order.
11/25 Posters delineating POUR pretest results and initial knowledge gap hung in PACU. Nurses read results, reeducated themselves on POUR and associated risks factors, and completed remediation questions to verify knowledge.
January 2014
Approved draft of new order set addendum for “patient voiding prior to discharge instructions” from Epic team.
February 2014
Order addendum to Post Anesthesia Care Unit Discharge instructions moved to production.
Emailed Danielle Schloffman (Magnet Program Director) POUR project results as Magnet submission for structural empowerment.
2/23 Facilitated journal club on POUR management
2/26 Presented POUR interventions to Clinical Quality and Risk Management Committee based on a urinary retention case that occurred in May 2013.
New Epic order for “voiding prior to discharge instructions” available for use.
March 2014
Chart audits conducted to assess use of voiding algorithm and new order.
AIP PACU nurses educated on order set addendum
3/3 Presented POUR PowerPoint, voiding algorithm, and new order at AOP Staff Meeting
3/27 Presented POUR PowerPoint, voiding algorithm, and new order to Perianesthesia Quality Improvement Council.
3/31 Emailed Ashley Walsh for template to write guideline utilizing POUR algorithm
April 2014
Chart audits conducted to assess use of voiding algorithm and new order.
4/1 Emailed GI, IR, and Pre/Post with POUR information and to gauge interest in implementing algorithm
4/17 Emailed Infection Prevention representative (Beth Carrier) the POUR algorithm as a reference for preventing postoperative urinary retention after discontinuing a Foley catheter
4/21 Emailed IR Educator (Gabrielle Shamsabadi) about implementing POUR. She discussed with IR RNs and will loosely implement the algorithm in recovery. (4/21)
4/29 Emailed Joanne Becker to get approval of 2 Unit Based Guidelines:
1. University of Colorado Hospital Guideline: Voiding Algorithm for Preventing Postoperative Urinary Retention
2. Updated: University of Colorado Hospital Guideline for Bladder Scan Use in Post Anesthesia Care Unit
May 2014
Communicated with Joanne Becker to organize Perioperative Guideline Taskforce meeting in order to approve the Voiding Algorithm for Preventing Postoperative Urinary Retention and updates to the Bladder Scan Use in Post Anesthesia Care Unit Guideline.
June 2014
Chart audits conducted to assess use of voiding algorithm and new order.
6/3 PACU Permanent Charge Nurse, Mary Hurlbert, voiced concerns that some PACU nurses are taking the guideline to literally and requiring most outpatients to void prior to discharge.
6/5 Wrote addendums to the Voiding Algorithm for Preventing Postoperative Urinary Retention guideline to clarify that every patient with risk factors does not have to void.
6/5-6/7 Received approval of guideline by the Perianesthesia Quality and Patient Safety Council.
6/10 Presented the Voiding Algorithm and Updated Bladder Scan Use Guidelines to the Perioperative Guideline Task Force.
6/11 Guidelines approved.
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