MP16-02: Implementation and Usability of an Electronic Medical Record Based Stent Tracker to Decrease Complications after Ureteral Stent Placement at a Diverse Urban Academic Center

Kavita Gupta*, Daniel Jacobs, Angela Alaimo, Kara Watts, Alexander Small, Bronx, NY

Introduction: Retained ureteral stents can result in complications. Stent trackers have been developed to prevent retained stents, but most have focused on patient-driven applications, and none have evaluated usability. We developed a simple electronic medical record based (EMR) ureteral stent tracker that mandates data entry from an operating room (OR) nurse when any ureteral stent is implanted and those stents that are overdue for removal are flagged. We evaluated outcomes before and after tracker implementation and conducted a usability assessment among OR nurses.

Methods: A retrospective analysis of patients with ureteral stents placed, as identified by our OR EMR implant tracker, between 7/1/19 – 3/30/21 was performed and compared to those placed after the stent tracker was launched (4/2021). Patient demographics, time to stent removal, positive urine culture pre-stent removal, and retained stents (defined as removal of stent greater than 6 months after insertion) were abstracted and compared between pre-tracker and post-tracker using chi square and t-tests. A 12-question usability survey was administered to the OR nurses across 3 hospital sites assessing usability of the tracker based on a 5-point Likert-based scale (ranging from 1 (strongly disagree) to 5 (strongly agree)).

Results: Data regarding 556 stents in 389 patients- 291 pre-tracker (cohort A) and 265 post-tracker (cohort B) – were compared. Average stent duration was significantly shorter in cohort B than cohort A (29.9 days (range 2-532 days) versus 57.9 days (range 8-52 days), p < 0.05, respectively). Cohort B also had fewer UTIs and retained stents compared to cohort A; 51 (17.5%) vs 8 (3%) UTIs, and 10 (3%) vs 2 (0.75%) retained stents, respectively. 23 OR nurses completed our usability survey; 96% of OR nurses reported that it took less than 1 minute to enter stent tracker data, and the mean Likert score regarding the usability was 4.26/5.

Conclusions: Implementation of an EMR ureteral stent tracker decreased the average stent duration and complications in patients prior to removal. OR nurses report a high level of usability, supporting its user-friendly interface. Given the numerous risks associated with retained ureteral stents, our program may serve as a resource for departments with an EMR system to optimize management and quality of care for patients who undergo ureteral stent insertion.

Source of Funding: None