Innovative Idea Earns National Award

Innovative idea earns national award for Transitional Care Hospital team

In treating chronically ill patients, a key piece of information for caregivers is fluid balance – being able to accurately measure the amount of fluid patients take in and their urinary output. Usually, monitoring of fluid balance is achieved by placement of an indwelling urinary catheter, which allows the caregiver to measure output – but catheters are expensive to place and maintain, and the sites are prone to infection.

Sharon Esau, Associate Professor of Medicine in the Division of Pulmonary and Critical Care Medicine and medical director of UVA’s Transitional Care Hospital, had a different idea: pediatric units weigh diapers to determine the urinary output of babies; why couldn’t the same method be used for adults?

In August 2012, TCH staff bought scales and started placing super absorbent pads under incontinent patients that can hold up to one liter of fluid. “While the pads absorb a great deal of liquid, their surface remains dry to prevent patients from getting skin infections,” said Michael McDaniel, director of TCH’s clinical operations.

The result: staff got more accurate output measures, which in turn helped them make better patient-care decisions. And by dramatically reducing urinary catheter use, the new process led to a 41% drop in catheter-associated infections in the first seven months of the initiative. The intervention has helped reduce length of stay by helping patients get better faster, and also reduced the costs associated with treating catheter-related urinary tract infections.

Dr. Esau and her TCH team received a 2013 Goldberg Innovation Award from the National Association of Long Term Hospitals for their work. The award is given annually for an innovative process or technology used in a long-term care hospital.