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SNQ Quality Mark
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Target Population

Patients undergoing lower urinary tract surgery


Description

Nursing care for catheter-related bladder discomfort (CRBD) was provided through the development of a CRBD assessment form, establishment of care guidelines, in-service education, shared decision-making, and health education promotion, aiming to improve bladder discomfort in postoperative patients with indwelling urinary catheters.


Key Highlights

  • Digitalize the CRBD assessment form to establish a common language between patients and nursing staff.

  • Use human-body diagrams for teaching and passing on care experience.

  • Establish CRBD care guidelines, including physician orders for antispasmodics and scheduled ward rounds.

  • 2015 Innovation Project: Shared Decision-Making in Healthcare.

  • Promote multimedia health education through posters and videos, and develop “Nursing Care for Bladder Discomfort Moments” to provide diverse health education resources.

  • In 2026, the CRBD health education videos are planned to be expanded into multiple languages, including Mandarin Chinese, Taiwanese, and Truku.

Service Data

  • From 2021 to 2026, the unit held a total of six in-service education sessions on CRBD nursing management, with 60 participants in total.

  • From 2021 to 2026, a total of 48 CRBD group health education sessions were conducted. The group health education satisfaction score was 4.5 out of 5 on average.

  • The service reached up to 13,729 inpatient person-days and received recognition from patients and their families.


Featured Outcomes

  • Incidence of severe CRBD: maintained at 0%.

  • Duration of indwelling urinary catheterization: reduced from 3 days to 1 day, and eventually to no catheter placement.

  • Rate of unplanned urinary catheter removal: 0%.

  • Rate of catheter-associated urinary tract infection caused by CRBD: 0%.

  • Incidence of inpatient falls: 0%.


Safety Outcomes

  • The rate of catheter-associated urinary tract infection in our hospital has remained lower than that of medical centers during the same period and international data.

  • The rate of unplanned urinary catheter removal was 0%, outperforming Medical Center A at 1.48%, Medical Center B at 0.78%, and international data at 0.32%.

  • The duration of indwelling urinary catheterization was reduced from 3 days to 1 day, and eventually to no catheter placement, outperforming the 7-day duration in medical intensive care units and international data showing a reduction from 15.8 to 12.3 days.


Satisfaction

The average inpatient satisfaction rate from 2025 to 2026 was 94%.


International Achievements

  • Poster presentation at the Taiwan Management Association in 2016.

  • Poster presentation at the Taiwan Management Association in 2017.

  • Professional discussion on CRBD at the International Medical Association in 2017.

  • Various monitoring indicators outperformed those of other medical centers, and there was limited international literature focusing on this topic.

  • Project submission in 2018: Improving the Completion Rate of Nursing Management for Catheter-Related Bladder Discomfort.

  • In 2022, professional reading sessions were used to transform nurses’ understanding of pain.


Benefits and Impacts

  • Participated in book publication and multimedia CD production: 16 CRBD health education multimedia care CDs and 23 health education manuals were produced.

  • Nurses shared their care experiences through magazine publications, including “Falling in Love with Human-Body Diagrams,” “No More Pain in the Lower Urinary Tract,” “Listening to the Voice of Pain,” and project presentations.

  • Following the honor of receiving the Bronze Award, the team was invited to contribute to the Taiwan Nurses Association’s teaching case book, Nursing Clinical Teaching Methods and Teaching Case Design.

  • A patient sent a flower basket to the nursing station to thank the nursing staff for managing bladder discomfort.

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Specialized NursingNational Biotechnology and Medicine Care Quality Award: 2018 bronze

Catheter-Related Bladder Discomfort Care

Lower Urinary Tract Surgery Patient Catheter Related Bladder Discomfort Symptoms Care
Organization
Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
Catheter-Related Bladder Discomfort Care
Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

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