ABSTRACT
Objective To discuss the effect of project management on improvement of the success rate of one trial urine catheterization and reduction of complications caused by catheterization care for male patients with liver failure.Methods Applying project management to train 14 registered nurses about the standard method of male patients' catheterization,then the mastering of the 6 points of catheterization were evaluated.From May 2009 to May 2012,146 male patients in our department were divided into the control group (84 cases)and the observation group (62 cases).The success rate of one trial urine catheterization and major nursing complications were evaluated.Results After using the project management,nurses could make significant improvement in mastering the 4 points,as the technique of lubricating the urethra,giving the assessment to urethral mucosa of the patients with liver function as Child-pugh C grade,common complications which caused by operation of catheterization and its circumvention technology.The success rate of one trial urine catheterization was higher,the injury rate of urethral mucosa and pain degree were lower in the observation group than those in the control group.Conclusions Project management can significantly improve the clinical operation capability of nurses and effectively decrease the catheterization complications.
ABSTRACT
Tokishakuyakusan has been used widely to treat various diseases including gynecological disorders. Currently, tokishakuyakusan is frequently used to treat female patients, while indications for use in male patients are unclear. Furthermore, there are few reports of male patients having been effectively treated with tokishakuyakusan or tokishakuyakusanryo. Here, we report four male patients successfully treated with tokishakuyakusanryo. Case 1 was an 84-year-old man who had uncontrolled nasal allergy, and treatment with tokishakuyakusanryo was effective in relieving the patient's allergy symptoms that were accompanied by chills and oketsu (blood stasis) findings. Case 2 was a 63-year-old man whose chief complaints were bronchial asthma, benign prostate hypertrophy, and nasal allergy. All his symptoms improved considerably with tokishakuyakusanryo and hangekobokuto, especially the symptoms of nasal allergy. Case 3 was a 70-year-old man whose chief complaint was persistent proteinuria. Tokishakuyakusanryo was prescribed, in consideration of his clinically observed condition, which included sensitivity to cold, blood stasis and fluid retention. His proteinuria disappeared four months later, along with his other complaints of chills, oketsu, and fluid retention. Case 4 was a 56-year-old man whose chief complaint was ulcerative colitis. He had responded well to treatment with ifuto, but he developed hypertension. His prescription was changed to tokishakuyakusanryo, a similar prescription that does not contain the Glycyrrhiza radix which can cause hypertension. Afterwards, his blood pressure decreased to normal levels and his abdominal symptoms remained stable. Nangai Yoshimasu published the opinion that tokishakuyakusan could be applied not only in female patients but also male patients. Additional reports on male cases would provide helpful information to clarify tokishakuyakusan indications in male patients.