Date of Conferral

8-11-2026

Date of Award

August 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Jill Sanko

Abstract

Acute urinary retention (AUR) is a common inpatient condition associated with complications such as urinary tract infections, prolonged hospitalization, and impaired mobility when not managed appropriately. Despite evidence supporting intermittent catheterization as a preferred first-line intervention for many patients with AUR, indwelling Foley catheters continue to be overused in acute care settings. Purpose: This Doctor of Nursing Practice (DNP) project evaluated whether staff education on a standardized AUR algorithm would improve evidence-based urinary retention management and reduce unnecessary Foley catheter utilization among nurses caring for adult hospitalized patients on a hematology and oncology unit in a Southern California acute care hospital. Methods: A staff education program was developed using current evidence and organizational practice standards. Educational content included a standardized AUR algorithm, bladder scanner utilization guidance, catheter selection criteria, and case-based learning scenarios. The intervention was delivered to frontline and charge nurses. Evaluation measures included education attendance records, structured chart audits, and unit-level catheter utilization data. Pre- and post-intervention outcomes were analyzed using frequencies, percentages, and comparative trend analysis. Results: Fifty-seven nurses completed the educational intervention, achieving 100% participation. Chart audit findings demonstrated improved adherence to evidence-based urinary retention management practices. The proportion of Foley catheter days associated with patients experiencing AUR who may have had opportunities for catheter avoidance or earlier removal decreased from 30% before implementation to 17% after implementation. Although the unit’s standardized utilization ratio (SUR) increased from 1.34 to 1.46 during the evaluation period, the increase coincided with a higher volume of urology patients requiring catheterization, which may have influenced overall utilization rates. Conclusions: Implementation of a standardized AUR algorithm combined with targeted nursing education was associated with a reduction in potentially avoidable Foley catheter utilization and improved evidence-based clinical decision-making. The project supported organizational goals related to patient safety, CAUTI prevention, quality improvement, and evidence-based nursing practice. Continued use of the algorithm, competency validation, and ongoing monitoring are recommended to sustain practice improvements.

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