Christopher Chambers, MD, PhD, FACS, vice president, Spectrum Health Research, and vascular surgeon, Spectrum Health Medical Group
L to R: Amaliya Tavakalyan, Erik Scholten
External urinary device
L to R: Eric Van Middendorp, Kris Emery, Andrew Heuerman
Jennifer Kaiser, PhD
One of the most common hospital-acquired infections is the catheter-associated urinary tract infection, or CAUTI. The Centers for Disease Control and Prevention estimates that more than 560,000 urinary tract infections per year have resulted in 13,000 deaths nationwide. Patients with a CAUTI on average have a 2- to 4-day longer hospital stay.
As health care facilities strive to reduce CAUTIs, a growing demand has emerged for external urinary collection devices that are safer and more comfortable than catheters.
Mary Tibbe, MSN, RN, CCRN-K, AGCNS-BC, cardiothoracic services clinical nurse specialist, Spectrum Health, noticed that when CAUTIs occurred in her patients, the infections were overwhelmingly showing up in females.
“We didn’t really have anything specifically suited for women,” Tibbe says. “Our only option was to prescribe antibiotics, which added to patient discomfort.”
Kris Emery, BSN, RN, clinical specialist, Spectrum Health Innovations (SHI), met with Tibbe to talk through the problem. Students from Grand Valley State University (GVSU) design and engineering classes worked on the design of an external urinary device, or EUD.
“Ideally, the device should keep moisture and fluids away from the skin,” Emery says. “And it shouldn’t cause any pressure against the patient’s body or cause any kind of skin breakdown or irritation. We wanted something that would be comfortable to wear, whether the person is lying down, sitting, or standing. It would have to support different sizes, connect to a drainage bag, be easy to apply, and not be difficult or painful to remove.”
Three classes of GVSU students were involved in the project. They found that the adhesive that fit a device securely to a woman’s body was the most challenging part of the project. Wicking, or pulling liquid away from the body, was another.
The device the students designed uses a shallow drainage basin that holds and drains urine down to a drainage bag. The bag is attached around the patient’s leg or near the patient’s side. It accommodates a female pelvis. A hydrogel adhesive wafer attaches to the patient and connects to a urinary cup. The cup attaches to the adhesive wafer. Finally, tubing connects the cup to the urine collection bag.
Tracy Hosford, MSN, RN, AGCNS-BC, clinical nurse specialist – burn/trauma, was one of about a dozen nurses who volunteered to test the new device.
“We had to wear the EUD for a 24-hour period,” Hosford says. “Being in health care gave me a better understanding of what a patient might need.”
Once the trial was over, Hosford and the other volunteers suggested improvements to SHI. The SHI gave their suggestions careful consideration, improving application and sizing.
Next came more testing, this time with 128 patients at two Spectrum Health facilities.
“SHI has been a recipient of 2 grants—funded through the Michigan Economic Development Corporation (MEDC)—to help develop the EUD for patient use,” says Brent Mulder, PhD, MBA, president, Spectrum Health Innovations.
The award is granted in order to enhance the commercial potential of a technology owned by any Michigan-based nonprofit.
“The external urinary device has enormous potential to decrease catheter-associated urinary tract infections,” says Christopher Chambers, MD, PhD, FACS, vice president, Spectrum Health Research, and vascular surgeon, Spectrum Health Medical Group. “Developing clinical evidence is necessary for widespread adoption, and, as it transitions from product development to investigation, the collaboration between the research and innovations teams to obtain grant funding and design the clinical research project has been outstanding and very productive.”
The EUD could help as many as 5 million patients in any given year.
“The external urinary device has enormous potential to decrease catheter-associated urinary tract infections.”
“The external urinary device will make the patient experience so much better, safer and more comfortable.”
“I was really impressed with SHI and how well they communicated with the nurses about the volunteer experience. They made it as easy as possible for us to do the trial. I’d be happy to volunteer again.”