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1.
Enferm. foco (Brasília) ; 11(2): 176-181, jul. 2020. tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1116005

ABSTRACT

Objetivo: Identificar os fatores associados ao desenvolvimento de Infecção do Trato Urinária Associada ao Cateter (ITU-AC) e mortalidade entre pacientes com cateter urinário. Metodologia: Estudo de coorte, prospectivo, com amostragem por conveniência envolvendo 790 pacientes com idade superior a 12 anos, em uso de cateter durante hospitalização. Os dados coletados do prontuário e fichas de notificação de infecção hospitalar foram analisados pelo programa SPSS. Resultados: Contribuíram para o desenvolvimento da ITU-AC a permanência com o cateter urinário por período >20 dias (OR 26,5; p<0,001), ser cateterizado mais de uma vez (OR 8,92; p<0,001) e hospitalização >30 dias (OR 26,8; p<0,001). Pacientes que desenvolveram ITU-AC apresentaram chance maior de mortalidade (OR 2,7; p<0,001). Conclusão:Frequência da inserção do dispositivo urinário, períodos prolongados de hospitalização e de permanência com o cateter contribuíram para o desenvolvimento de ITU-AC, e as chances de mortalidade foram aumentadas entre pacientes com essa infecção. (AU)


Objective: To identify factors associated with the development of Catheter-related Urinary Tract Infection (CR-UTI) and mortality among patients using urinary catheter. Methodology: Prospective cohort study in a convenience sample of 790 patients older than 12 years using catheter during hospitalization.[A1] The data collected from medical records and hospital infection notification were analyzed using the SPSS program. Results: Permanence with the urinary catheter >20 days (OR 26.5; p<0.001), being catheterized more than once (OR 8.92; p<0.001) and hospitalization >30 days (OR 26.8; p<0.001) contributed to the development of CR-UTI. Patients who developed CR-UTI presented a greater chance of mortality (OR 2.7; p<0.001). Conclusion: Frequency of urinary device insertion, prolonged periods of hospitalization and of permanence with the catheter contributed to the development of CR-UTI, and the chances of mortality were increased among patients with this infection. (AU)


Objetivo: Identificar los factores asociados con el desarrollo de Infección del Tracto Urinario Asociada con el Catéter (ITU-AC) y la mortalidad entre los pacientes que usan catéter urinario. Metodología: Estudio de cohorte, prospectivo con una muestra de conveniencia de 790 pacientes mayores de 12 años, que usan catéter durante su hospitalización. Los datos recopilados de los registros médicos y los formularios de notificación de infección nosocomial fueron analizados por el programa SPSS. Resultados: Contribuyendo al desarrollo de la (ITU-AC) la permanencia con el catéter urinario por un plazo >20 días (OR 26,5; p <0,001), tener recibido catéter más de una vez (OR 8,92; p<0,001) y hospitalización >30 días (OR 26,8; p<0,001). Los pacientes que desarrollaron (ITU-AC) presentaron una mayor posibilidad de mortalidad (OR 2,7; p<0,001). Conclusión: Frecuencia de inserción del dispositivo urinario, períodos prolongados de hospitalización y de permanencia con el catéter contribuyeron al desarrollo de (ITU-AC), y las posibilidades de mortalidad aumentaron entre los pacientes con esta infección. (AU)


Subject(s)
Urinary Tract Infections , Urinary Catheterization , Infection Control , Catheter-Related Infections , Nursing Care
2.
REME rev. min. enferm ; 23: e-1171, jan.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1005432

ABSTRACT

Objetivo: elaborar e validar material educativo escrito e ilustrativo para homens em uso de cateter urinário de demora no ambiente domiciliar. Material e Método: letramento em saúde, educação em saúde, modelos de validação de conteúdo diagnóstico de Enfermagem e Suitability Assessment of Educational Materials (SAM) foram referenciais teóricos e metodológicos utilizados. Resultados e discussão: realizaram-se a validação de conteúdo e aparência do material com base na avaliação de 30 peritos. Quanto ao conteúdo, todas as orientações foram validadas com escore final igual ou superior a 0,80. A aparência foi avaliada positivamente em todos os itens por 89,7% dos peritos. As sugestões contribuíram sobremaneira para melhor qualidade do material. Conclusão: considera-se que a validação de conteúdo e aparência com base nos referenciais utilizados pode contribuir como método de validação de materiais educativos em saúde.(AU)


Objective: to elaborate and validate a written and illustrative educational material aimed at men using home indwelling urinary catheters. Material and Method: health literacy, health education, nursing content validation models, and the Suitability Assessment of Material (SAM) were the theoretical and methodological references used. Results and discussion: the content and appearance of the material were validated based on the evaluation of 30 experts. Regarding the content, all guidelines were validated with a final score equal to or greater than 0.80. The appearance of the material was evaluated positively in all items by 89.7% of the experts. The suggestions have contributed greatly to increase the quality of the material. Conclusion: it is considered that the validation of content and appearance based on the references used can contribute as a validation method of educational materials in health.(AU)


Objetivo: elaborar y validar material educativo escrito e ilustrativo para hombres que usan catéter urinario de demora en el domicilio. Material y método: alfabetismo en salud, educación en salud, modelos de validación de contenido diagnóstico en enfermería y Suitability Assessment of Educational Materials (SAM) sirvieron como referentes teóricos. Resultados y discusión: se validó el contenido y la apariencia del material en base a la evaluación de 30 especialistas. Todas las orientaciones referentes al contenido recibieron puntuación final igual o superior a 0,80. El 89,7% de los especialistas evaluó positivamente todos los puntos referentes a la apariencia. Las sugerencias fueron de gran utilidad para mejorar la calidad del material. Conclusión: se considera que la validación de contenido y apariencia en base a los referentes empleados puede ayudar como método de validación de material educativo en salud.(AU)


Subject(s)
Humans , Male , Self Care , Urinary Catheterization , Health Education , Patient Education as Topic , Men's Health
3.
REME rev. min. enferm ; 23: e-1263, jan.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1047867

ABSTRACT

As infecções do trato urinário relacionadas ao cateterismo urinário de demora estão entre as mais frequentes em hospitais. Existem várias recomendações para a prevenção de infecções, porém ainda se questiona a necessidade de utilizar antissépticos para a limpeza periuretral. Objetivo: este estudo objetivou analisar as evidências, na literatura, acerca do tema. Método: foi realizada revisão sistemática utilizando-se as bases de dados Biblioteca Virtual em Saúde, Medline, Embase, Web of Science e Cumulative Index to Nursing & Allied Health Literature. Foram incluídos ensaios clínicos que avaliaram as taxas de infecção do trato urinário/bacteriúria e que utilizaram soluções antissépticas e água na limpeza periuretral. Resultados: de 211 estudos, três foram considerados metodologicamente adequados de acordo com a Escala de Jadad. Todos os estudos mostraram que não há diferenças significativas nas taxas de ITU/ bacteriúria quando comparado o uso de água com antisséptico (clorexidina ou povidona-iodo). Conclusão: concluiu-se que o uso de água na limpeza periuretral parece não aumentar o risco de adquirir infecção/bacteriúria.(AU)


Urinary tract infections related to indwelling urinary catheterization are among the most frequent in hospitals. There are many recommendations for the prevention of infections, but the need to use antiseptics for periurethral cleaning is still questioned. Objective: This study aimed to analyze the evidence on the theme in the literature. Method: A systematic review was performed using the following databases: Biblioteca Virtual em Saúde, Medline, Embase, Web of Science and Cumulative Index to Nursing & Allied Health Literature. Clinical trials were included which assessed the infection rates of the urinary tract/bacteriuria and which used antiseptic solutions and water in the periurethral cleaning. Results: Of 211 studies, three were considered as methodologically adequate according to the Jadad Scale. All of the studies showed that there is no significant difference in the rates of UTI/bacteriuria when compared to the use of water with antiseptic (chlorhexidine or povidone-iodine). Conclusion: It was concluded that the use of water in the periurethral cleaning seems not to augment the risk of acquiring infections/bacteriuria.(AU)


Las infecciones del tracto urinario relacionadas con el cateterismo urinario permanente se encuentran entre las infecciones hospitalarias más comunes. Existen recomendaciones para la prevención de infecciones, pero aún se cuestiona la necesidad de usar antisépticos para la limpieza periuretral. Objetivo: analizar la evidencia en la literatura sobre el tema. Método: se realizó una revisión sistemática utilizando las bases de datos de la Biblioteca Virtual de Salud, Medline, Embase, Web of Science y Cumulative Index to Nursing & Allied Health Literature. Se incluyeron ensayos clínicos que evaluaron las tasas de infección urinaria / bacteriuria y el uso de soluciones antisépticas y agua para la limpieza periuretral. Resultados: de 211 estudios, tres se consideraron metodológicamente adecuados según la escala de Jadad. Todos los estudios mostraron que no hay diferencias significativas en las tasas de infección urinaria / bacteriuria en comparación con el uso de agua antiséptica (clorhexidina o povidona yodada). Conclusión: el uso de agua para la limpieza periuretral no parece aumentar el riesgo de contraer infección / bacteriuria.(AU)


Subject(s)
Urinary Tract Infections , Urinary Catheterization , Anti-Infective Agents, Urinary , Povidone-Iodine , Water , Chlorhexidine
4.
REME rev. min. enferm ; 23: e-1219, jan.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1051145

ABSTRACT

OBJETIVO: analisar o impacto da educação permanente na prevenção e no controle da infecção do trato urinário em pacientes submetidos ao procedimento de cateterismo vesical de demora. MÉTODO: estudo quase experimental do tipo antes e depois, com intervenção educacional sobre os cuidados relacionados a inserção, manutenção e retirada do cateter vesical de demora. Aplicação de escala de 20 questões com 124 enfermeiros e técnicos de Enfermagem para medida do conhecimento. Realizou-se análise da mudança do padrão de comportamento do pré-teste para o pós-teste, por meio de escala global, e análise de covariância, nos quais se ajustou a reta de regressão por categoria profissional. Para analisar o conhecimento e as condutas do procedimento de cateterismo vesical de demora, foram utilizados os testes de Levene para igualdade de variâncias, teste t para amostras independentes, testes inferenciais não paramétricos e teste qui-quadrado. RESULTADOS: na análise global do estudo, partindo das 20 questões consideradas, observou-se que, em média, os técnicos de Enfermagem em comparação aos enfermeiros obtiveram ganho de sete pontos do pré-teste para o pós-teste (≅12,00 para ≅19,00), enquanto os enfermeiros obtiveram 4,0 pontos (≅16 para ≅20,00). CONCLUSÃO: a intervenção educacional aumentou significativamente o conhecimento dos profissionais de saúde sobre o procedimento de cateterismo vesical de demora e colaborou para a redução da taxa de infecção das infecções de trato urinário na instituição, bem como uma evolução no patamar de conhecimento, principalmente dos técnicos de Enfermagem após as intervenções educativas.(AU)


Objective: to analyze the impact of continuing education on the prevention and the control of urinary tract infection in patients undergoing a delayed bladder catheterization procedure. Method: a quasi-experimental study of before and after type with an educational intervention on the care related to insertion, maintenance, and removal of the delayed bladder catheter. We applied a scale of 20 questions with 124 nurses and Nursing technicians to measure their knowledge. We analyzed the change in the behavioral pattern from the pretest to the posttest, by a global scale, and covariance analysis, which adjusted the regression line by professional category. To analyze the knowledge and behaviors of the delayed bladder catheterization procedure, Levene's tests for equality of variance, t-test for independent samples, nonparametric inferential tests, and chi-square tests were used. Results: in the overall analysis of the study, starting from the 20 questions considered, it was observed that, on average, Nursing technicians compared to nurses obtained seven points from the pretest to the posttest (≅12,00 to ≅19,00), while nurses scored 4.0 points (≅16 to ≅20.00). Conclusion: the educational intervention significantly increased...(AU)


Objetivo: analizar el impacto de la educación continua en prevención y control de infecciones del tracto urinario en pacientes sometidos a procedimiento de cateterismo vesical intermitente. Método: estudio cuasi-experimental realizadas antes y después del procedimiento, con intervención educativa sobre cuidados con la inserción, mantenimiento y extracción de la sonda vesical intermitente. Se utilizó una escala de 20 preguntas con 124 enfermeros y técnicos de enfermería para medir el conocimiento. Se analizó el análisis del cambio en el patrón de comportamiento de la prueba previa y de la prueba posterior, mediante una escala global, y análisis de covarianza, que ajustó la línea de regresión por categoría profesional. Para analizar el conocimiento y las conductas del procedimiento de cateterismo vesical intermitente, se emplearon las pruebas de Levene para igualdad de varianzas, prueba t para muestras independientes, pruebas inferenciales no paramétricas y chi-cuadrado. Resultados: en el análisis general del estudio, basado en las 20 preguntas consideradas, se observó que, en promedio, los técnicos de enfermería en comparación con los enfermeros obtuvieron siete puntos más de la prueba previa a la posterior (≅12,00 para ≅19,00), mientras que los enfermeros obtuvieron 4,0 puntos (≅16 para ≅20,00). Conclusión: la intervención educativa aumentó significativamente el conocimiento de los profesionales de la salud sobre el procedimiento de cateterismo vesical intermitente y contribuyó a la reducción de la tasa de infección entre las infecciones del tracto urinario en la institución, así como a aumentar el nivel de conocimiento, especialmente de los técnicos de Enfermería después de las intervenciones educativas.(AU)


Subject(s)
Humans , Urinary Tract Infections/prevention & control , Urinary Catheterization , Education, Nursing, Continuing , Disease Prevention , Education, Continuing
5.
Article in Portuguese | LILACS (Americas) | ID: biblio-1021451

ABSTRACT

Justificativa e Objetivos: As infecções do trato urinário (ITU) relacionadas ao uso do cateter vesical de demora (CVD) (ITU-RC) apresentam alta prevalência em unidades de terapia intensiva (UTI). Desse modo, objetivou-se determinar a prevalência e fatores relacionados à ITU-RC na UTI. Métodos: Pesquisa documental e retrospectiva de abordagem quantitativa, realizada por meio da análise dos prontuários de todos os pacientes internados em uma UTI de um hospital universitário do norte de Minas Gerais no período de janeiro de 2013 a dezembro de 2014. A coleta e análise de dados foram baseados nos prontuários e fichas de notificação das infecções relacionadas à assistência à saúde (IRAS). Adotou-se regressão de Poisson com intervalo de confiança de 95%. Resultados: Dos 169 pacientes analisados, 145 (85,8%) foram submetidos a cateterizações vesicais. A prevalência de ITU-RC foi de 16,6%. Os fatores associados foram tempo de internação ≥15 dias (Razão de prevalência: 4,6) e uso do cateter vesical ≥10 dias (Razão de prevalência: 7,4). Conclusão: O tempo de internação e permanência do CVD está diretamente relacionado à ocorrência de ITU-RC, direcionando para o compromisso dos profissionais da saúde no monitoramento da permanência, avaliação contínua e indicação estrita do uso do CVD.(AU)


Background and Objectives: Urinary tract infections (UTI) related to the use of long-term urinary catheter (LUC) (ITU-LUC) present high prevalence in intensive care units (ICU). Therefore, the objective of the present study is to determine the prevalence and factors associated with UTI-LUC at ICU. Methods: Retrospective documentary research with quantitative approach conducted by the analyses of medical records from all patients admitted to the ICU from a University Hospital located in the north region of the State of Minas Gerais, from January 2013 to December 2014. Data collection and analysis were based in the medical records and notification sheets of healthcare-associated infections (HAI). Poisson regression was adopted with a 95% confidence interval. Results: From 169 patients analyzed, 145 (85.8%) underwent bladder catheterization. The prevalence of UTI-LUC was 16.6%. The factors associated were hospitalization time ≥ 15 days (prevalence ratio: 4.6) and use of urinary catheter ≥ 10 days (prevalence ratio: 7.4). Conclusion: Time of hospitalization and LUC permanence was directly related to the occurrence of UTI-LUC, pointing out to the commitment of health care professionals in the monitoring of time of hospitalization, continuous evaluation and strict indication of LUC use.(AU)


Justificación y Objetivos: Las infecciones del tracto urinario (ITU) relacionadas con el uso del catéter vesical de demora (CVD) (ITU-RC) representan una elevada prevalencia de las infecciones en la unidad de terapia intensiva (UTI). De este modo, se objetivó determinar la prevalencia y factores asociados a la ITU-RC en la UTI. Métodos: Investigación documental y retrospectiva de abordaje cuantitativo, realizada por medio del análisis de los prontuarios de todos los pacientes internados en una UTI de un hospital universitario del norte de Minas Gerais, de enero de 2013 a diciembre de 2014. La recolección y análisis de datos se basaron en los prontuarios de los pacientes internados en la UTI y en las fichas de notificación de las IRAS. Se adoptó la Regresión de Poisson con intervalo de confianza del 95,0%. Resultados: De los 169 pacientes analizados, 145 (85,8%) fueron sometidos a cateterizaciones vesicales. La prevalencia de ITU-RC fue del 16,6%. Los factores asociados fueron tiempo de internación ≥15 días (Razón de prevalencia: 4,6) y uso del catéter vesical ≥10 días (Razón de prevalencia: 7,4). Conclusiones: El tiempo de internación y permanencia del CVD fue directamente proporcional a la ocurrencia de ITU-RC, dirigiendo hacia el compromiso de los profesionales de la salud en el monitoreo de la permanencia, evaluación continua e indicación estricta del uso del CVD.(AU)


Subject(s)
Humans , Urinary Tract Infections , Urinary Catheterization , Cross Infection , Catheters , Intensive Care Units
6.
Belo Horizonte; s.n; 2019. 96 p. ilus, tab.
Thesis in Portuguese | LILACS (Americas), BDENF | ID: biblio-1050574

ABSTRACT

O cateterismo urinário de demora é um procedimento amplamente utilizado em pacientes internados e está relacionado com altas taxas de bacteriúria assintomática e infecção do trato urinário. Para evitar essas doenças, a limpeza da região periuretral antes da inserção do cateter é uma importante conduta, com fins de reduzir a entrada de microrganismos dessa região através da uretra. Guias de prática clínica recomendam que o cateterismo urinário de demora deva ser realizado com técnica asséptica, porém não há consenso sobre qual solução é mais eficaz para sua realização, com vistas à redução das infecções do trato urinário e da bacteriúria assintomática. O objetivo é de avaliar o efeito da limpeza periuretral nas incidências de bacteriúria assintomática e de infecção do trato urinário com o uso de três soluções (água, sabão e gluconato de clorexidina aquosa 2%; gluconato de clorexidina degermante 2%, água bi-destilada e gluconato de clorexidina aquosa 2%; e povidona-iodo 10% degermante, água bi-destilda e povidona-iodo aquoso 1%) em pacientes adultos internados em hospital terciário submetidos ao cateterismo urinário de demora. Trata-se de uma pesquisa realizada em duas etapas: revisão sistemática da literatura e ensaio clínico randomizado sem mascaramento do pesquisador. Foi realizado em um hospital de grande porte de Belo Horizonte ­ Minas Gerais. A população foi constituída por pacientes internados e que foram elegíveis para serem submetidos ao cateterismo urinário de demora. A amostra foi de 28 pacientes, sendo alocados aleatoriamente nos grupos: sabão (n=11) e grupo antisséptico (n=17). Uroculturas foram coletadas no momento da inserção e 24h após. A incidência global de bacteriúria assintomática foi de 7,14%, no grupo sabão foi de 9,1% e no grupo antissépticos foi de 5,9%. Não houve nenhum caso de infecção do trato urinário. A regressão logística mostrou que não há diferenças estatisticamente significativas nas incidências de bacteriúria assintomática quando realizada a limpeza com sabão ou antisséptico (clorexidina ou povidona-iodo). A redução do risco relativo mostrou uma redução de 36% de adquirir bacteriúria assintomática.(AU)


Indwelling urinary catheterization is a procedure that is used in inpatients and is related to high rates of asymptomatic bacteriuria and urinary tract infection. To prevent these diseases, cleaning the periurethral region prior to catheter insertion is an important approach, reducing the entry of microorganisms from this region through the urethra. Clinical practice guidelines recommend that indwelling urinary catheterization should be performed with aseptic technique, but there is no consensus on which solution is most effective for reducing urinary tract infections. The objective is to evaluate the effect of periurethral cleansing on the incidence of asymptomatic bacteria and urinary tract infections with the use of three solutions (water, soap and 2% aqueous chlorhexidine gluconate; chlorhexidine gluconate 2%, distilled water and 2% aqueous chlorhexidine; and 10% povidone-iodine, distilled water and 1% aqueous povidone-iodine) in adult patients admitted to a tertiary hospital submitted to the indwelling urinary catheterization. This is a two-step research: systematic literature review and randomized clinical trial without researcher's masking. It was performed in a large hospital in Belo Horizonte - MG. The population was composed by inpatients who were eligible to undergo indwelling urinary catheterization. A sample of 28 patients was randomly allocated into groups: soap (n = 11) and antiseptic group (n = 17). Urine cultures were collected at insertion and 24h after. The overall incidence of asymptomatic bacteriuria was 7.14%, on soap group was 9.1% and on antiseptic group was 5.9%. There were no cases of urinary tract infection. Logistic regression showed no statistically significantly differences in the incidence of asymptomatic bacteriuria when cleaned with soap or antiseptic (chlorhexidine or povidone-iodine). A relative risk reduction showed a 36% reduction from acquiring asymptomatic bacteriuria.(AU)


Subject(s)
Humans , Adult , Urinary Tract Infections/drug therapy , Urinary Catheterization/methods , Asepsis/methods , Povidone-Iodine , Chlorhexidine , Randomized Controlled Trial , Academic Dissertation
7.
Asia Pacific Allergy ; (4): e29-2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-762880

ABSTRACT

Chlorhexidine is a commonly used antiseptic and disinfectant in the health-care setting. Anaphylaxis to chlorhexidine is a rare but potentially life-threatening complication. Epidemiologic data suggest that the cases of chlorhexidine allergy appears to be increasing. In this article we report a life-threatening anaphylactic shock with cardiorespiratory arrest, during urethral catheterization due to chlorhexidine. The authors also performed a literature review of PubMed library of anaphylactic cases reports due to this antiseptic between 2014 and 2018, demonstrating the increase in the number of cases occurring worldwide and the importance of detailed anamnesis and appropriate diagnostic workup of allergic reactions to disinfectants.


Subject(s)
Anaphylaxis , Chlorhexidine , Disinfectants , Hypersensitivity , Urinary Catheterization , Urinary Catheters
8.
Article in English | WPRIM (Western Pacific) | ID: wprim-786364

ABSTRACT

Acute pyelonephritis (APN) should be detected and treated as soon as possible to reduce the risk of the development of acquired renal scarring. However, in the medical field, urine culture results are not available or considered when the prompt discrimination of APN is necessary and empirical treatment is started. Furthermore, urine culture cannot discriminate APN among children with febrile urinary tract infection (UTI) (pyelitis, lower UTI with other fever focus). Therefore, the usefulness of urine culture for diagnostic purposes is small and the sampling procedure is invasive. Congenital hypoplastic kidney is the most common cause of chronic kidney injury in children. Thus, it is desirable that a main target be detected as early as possible when imaging studies are performed in children with APN. However, if APN does not recur, no medical or surgical treatment or imaging studies would be needed because the acquired renal scar would not progress further. Therefore, the long-term prognosis of APN in young children, particularly infants, depends on the number of recurrent APN, not other febrile UTI. New methods that enable prompt, practical, and comfortable APN diagnosis in children are needed as alternatives to urinary catheterization for urine culture sampling.


Subject(s)
Child , Cicatrix , Diagnosis , Discrimination, Psychological , Fever , Humans , Infant , Kidney , Methods , Prognosis , Pyelitis , Pyelonephritis , Urinary Catheterization , Urinary Catheters , Urinary Tract Infections
9.
Article in English | WPRIM (Western Pacific) | ID: wprim-741831

ABSTRACT

Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnet-attached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).


Subject(s)
Catheters , Child , Eating , Emergencies , Endoscopes , Endoscopy , Esophagus , Fluoroscopy , Foreign Bodies , Gastrointestinal Tract , Humans , Methods , Upper Gastrointestinal Tract , Urinary Catheterization
10.
Acta cir. bras ; 33(5): 408-414, May 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-949346

ABSTRACT

Abstract Purpose: To evaluate the clinical stenosis or precursor histological changes that ureteral access sheaths commonly used in ureteroscopic surgeries may cause in the long term in ureter. Methods: In this study, the animals were divided into 9 groups and according to their groups, ureters of the rabbits were endoscopically fitted with 2F and 3F ureter catheters. The catheters were left in place and withdrawn after a specified period of time. All the ureters were excised and evaluated macroscopically, microscopically and histologically. Ureter diameters were measured and FGF-2 (+) labeled fibroblasts were counted in connective tissue as stenosis precursors. Results: Macroscopically or microscopically, no stenosis was found in any group. The ureter diameter of the group that were catheterized for the longest time with the catheter that had the widest diameter was significantly lower than the group with the shorter duration and the catheter with the narrower diameter and the control group. When the groups were compared in terms of their FGF values, there was a significant difference in FGF-2 counts at all three ureter levels (p <0.05). Conclusion: The use of ureteral access sheath may lead to histological changes, as its diameter and duration increase.


Subject(s)
Animals , Male , Rats , Ureter/surgery , Urologic Diseases/surgery , Urinary Catheterization/instrumentation , Ureteroscopy/instrumentation , Ureter/pathology , Statistics, Nonparametric , Disease Models, Animal
11.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-973262

ABSTRACT

OBJETIVO: avaliar se há diferença no conhecimento teórico de alunos de Enfermagem acerca do cateterismo vesical de demora entre alunos que aprenderam o procedimento pelo método tradicional de ensino e pelo método da simulação realística. MÉTODO: trata-se de estudo de coorte retrospectivo, cuja amostra foi de 58 alunos de Enfermagem de uma universidade pública do interior de Minas Gerais. Os dados foram coletados entre setembro e outubro de 2016, utilizando questionário validado auto aplicado, e analisados utilizando estatística descritiva e teste de Mann-Whitney, com intervalo de confiança de 95%. RESULTADOS: a média geral de acertos foi de 6,74, indicando conhecimento satisfatório. Não houve diferença no nível de conhecimento entre os grupos comparados (p = 0, 72). CONCLUSÕES: sugerem-se novos estudos que comparem o nível de conhecimento prático de estudantes que aprenderam essa habilidade com a metodologia tradicional e com a simulação realística.


OBJECTIVE: to evaluate if there is a difference in the theoretical knowledge of Nursing students about urinary catheterization delay between students who learned the procedure by the traditional method of teaching and by the realistic simulation method. METHOD: it is a retrospective cohort study, whose sample was 58 nursing students from a public university in the interior of Minas Gerais. Data were collected between September and October 2016, using a validated self-administered questionnaire, and analyzed using descriptive statistics and Mann-Whitney test, with a confidence interval of 95%. RESULTS: the overall average of hits was 6.74, indicating satisfactory knowledge. There was no difference in the level of knowledge between the groups compared (p = 0.72). CONCLUSIONS: new studies were suggested comparing the level of practical knowledge of students who have learned this skill with traditional methodology and with realistic simulation.


OBJETIVO: evaluar si hay diferencia en el conocimiento teórico de alumnos de enfermería acerca del cateterismo urinario permanente entre alumnos que aprendieron el procedimiento por el método tradicional de enseñanza, y por el método de la simulación realista. MÉTODO: se trata de estudio de cohorte retrospectivo, cuya muestra fue de 58 alunos de enfermería de una universidad pública del interior de Minas Gerais. Los datos fueron recolectados entre septiembre y octubre de 2016, utilizando cuestionario validado auto aplicado, y analizados utilizando estadística descriptiva e teste de Mann-Whitney, con un intervalo de confianza del 95%. RESULTADOS: el promedio general de aciertos fue de 6,74, indicando conocimiento satisfactorio. No hubo diferencia en el nivel de conocimiento entre los grupos comparados (p = 0, 72). CONCLUSIONES: se sugieren nuevos estudios que comparen el nivel de conocimiento práctico de estudiantes que aprendieron esta habilidad con la metodología tradicional, y con la simulación realista.


Subject(s)
Male , Female , Humans , Knowledge , Nursing , Simulation Technique , Teaching , Urinary Catheterization
12.
Asian Spine Journal ; : 1100-1105, 2018.
Article in English | WPRIM (Western Pacific) | ID: wprim-739291

ABSTRACT

STUDY DESIGN: Prospective observational study. PURPOSE: To determine the incidence of postoperative urinary retention (POUR) in patients undergoing elective posterior lumbar spine surgery and identify the risk factors associated with the development of POUR. OVERVIEW OF LITERATURE: POUR following surgery can lead to detrusor dysfunction, urinary tract infections, prolonged hospital stay, and a higher treatment cost; however, the risk factors for POUR in spine surgery remain unclear. METHODS: A prospective, consecutive analysis was conducted on patients undergoing elective posterior lumbar surgery in the form of lumbar discectomy, lumbar decompression, and single-level lumbar fusions during a 6-month period. Patients with spine trauma, preoperative neurological deficit, previous urinary disturbance/symptoms, multiple-level fusion, and preoperative catheterization were excluded from the study. Potential patient- and surgery-dependent risk factors for the development of POUR were assessed. Univariate analysis and a multiple logistical regression analysis were performed. RESULTS: A total of 687 patients underwent posterior lumbar spine surgery during the study period; among these, 370 patients were included in the final analysis. Sixty-one patients developed POUR, with an incidence of 16.48%. Significant risk factors for POUR were older age, higher body mass index (BMI), surgery duration, intraoperative fluid administration, lumbar fusion versus discectomy/decompression, and higher postoperative pain scores (p < 0.05 for all). Sex, diabetes, and the type of inhalational agent used during anesthesia were not significantly associated with POUR. Multiple logistical regression analysis, including age, BMI, surgery duration, intraoperative fluid administration, fusion surgery, and postoperative pain scores demonstrated a predictive value of 92% for the study population and 97% for the POUR group. CONCLUSIONS: POUR was associated with older age, higher BMI, longer surgery duration, a larger volume of intraoperative fluid administration, and higher postoperative pain scores. The contribution of postoperative pain scores in the multiple regression analysis was a significant predictor of POUR.


Subject(s)
Anesthesia , Body Mass Index , Catheterization , Catheters , Decompression , Diskectomy , Health Care Costs , Humans , Incidence , Length of Stay , Observational Study , Pain, Postoperative , Postoperative Complications , Prospective Studies , Risk Factors , Spinal Fusion , Spine , Urinary Catheterization , Urinary Retention , Urinary Tract Infections
13.
Article in English | WPRIM (Western Pacific) | ID: wprim-715216

ABSTRACT

BACKGROUND: Patients who undergo urinary catheterization may experience postoperative catheter-related bladder discomfort (CRBD). Previous studies have indicated that drugs with antimuscarinic effects could reduce the incidence and severity of CRBD. Accordingly, this study was carried out to investigate whether nefopam, a centrally acting analgesic with concomitant antimuscarinic effect, reduces the incidence and severity of CRBD. METHODS: Sixty patients with American Society of Anesthesiologists physical status I and II and aged 18–70 years who were scheduled to undergo elective ureteroscopic litholapaxy participated in this double-blinded study. Patients were divided into control and nefopam groups, comprising 30 patients each. In the nefopam group, 40 mg nefopam in 100 ml of 0.9% saline was administered intravenously. In the control group, only 100 ml of 0.9% saline was administered. All patients had a urethral catheter and ureter stent inserted during surgery. The incidence and severity of CRBD, numerical rating scale (NRS) score of postoperative pain, rescue pethidine dose, and side effects were recorded in the post-anesthesia care unit after surgery. RESULTS: The incidence (P = 0.020) and severity (P < 0.001) of CRBD were significantly different between the control group and the nefopam group. The NRS score of postoperative pain (P = 0.006) and rescue dose of pethidine (P < 0.001) were significantly higher in the control group than in the nefopam group. CONCLUSIONS: Intravenous administration of nefopam in patients scheduled to undergo ureteroscopic litholapaxy reduced the incidence and severity of CRBD, NRS score of postoperative pain and analgesic requirements.


Subject(s)
Administration, Intravenous , Humans , Incidence , Lithotripsy , Meperidine , Nefopam , Pain, Postoperative , Stents , Ureter , Ureteroscopy , Urinary Bladder , Urinary Catheterization , Urinary Catheters
14.
Rev Rene (Online) ; 19: e3315, jan. - dez. 2018.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-909033

ABSTRACT

Objetivo: adaptar transculturalmente e validar o conteúdo do Intermittent Self-Catheterization Questionnaire para língua portuguesa. Métodos: estudo metodológico envolvendo a validação transcultural, conduzido em cinco fases: tradução inicial, síntese da tradução, tradução de volta à língua original, revisão por comitê de juízes, pré-teste da versão final, com 30 pessoas com lesão medular traumática que realizavam autocateterismo, e a validação de conteúdo com 17 juízes. Resultados: foram realizadas alterações na versão em português do Intermittent Self-Catheterization Questionnaire quanto ao aspecto semântico, idiomático, experimental e conceitual. O pré-teste revelou que os itens da versão traduzida e adaptada eram de fácil compreensão e interpretação. O Índice de Validação de Conteúdo foi 0,92. Conclusão: o Intermittent Self-Catheterization Questionnaire, versão traduzida foi adaptado transculturalmente para o português brasileiro e validado com Índice de Validação de Conteúdo satisfatório, sendo considerado válido para verificar a qualidade de vida das pessoas com afecções neurológicas que realizam autocateterismo urinário. (AU)


Subject(s)
Nursing , Spinal Cord Injuries , Translating , Urinary Catheterization , Validation Study
15.
Article in Chinese | WPRIM (Western Pacific) | ID: wprim-775536

ABSTRACT

Artificial conduits, including ureteral stents and catheters, are used widely as drainage tools in the urinary system. However, various bacteria in the urine and long duration of insertion can arouse the biofilm formation on the pipeline surface, which calls for effective antibacterial strategy. In this article, the mechanism of Catheter Associated Urinary Tract Infections (CAUTI) is explained from the perspective of etiology. Then, the biofilm formation conditions and the features of urine are analyzed, the antibacterial agents and approaches suitable for ureteral stents and catheters are introduced and their pros and cons are discussed respectively.


Subject(s)
Anti-Bacterial Agents , Catheters , Drainage , Humans , Stents , Urinary Catheterization , Urinary Tract Infections
16.
National Journal of Andrology ; (12): 138-141, 2018.
Article in Chinese | WPRIM (Western Pacific) | ID: wprim-775206

ABSTRACT

Objective@#To explore the strategies of preserving urinary continence in transurethral plasmakinetic enucleation of the prostate (PKEP) for benign prostate hyperplasia (BPH).@*METHODS@#We treated 65 BPH patients by PKEP with preservation of urinary continence (UC-PKEP), which involved protection of the external urethral sphincter in the beginning of surgery, proper preservation of the anterior lobe of the prostate to protect the internal urethral sphincter in the middle, and preservation of the integrity of the bladder neck towards the end. We compared the postoperative status of urinary continence of the patients with that of the 54 BPH cases treated by complete plasmakinetic enucleation of the prostate (Com-PKEP).@*RESULTS@#All the operations were performed successfully with the urinary catheters removed at 5 days after surgery. In comparison with Com-PKEP, UC-PKEP achieved evidently lower incidence rates of urinary incontinence at 24 hours (31.49% vs 13.85%, P 0.05), and 3 months (3.70% vs 0%, P >0.05) after catheter removal. Compared with the baseline, the maximum urinary flow rate (Qmax) was significantly improved postoperatively in both the Com-PKEP ([7.43 ± 3.26] vs [20.58 ± 3.22] ml, P <0.05) and the UC-PKEP group ([8.04 ± 2.28] vs [20.66 ± 3.08] ml, P <0.05).@*CONCLUSIONS@#Transurethral PKEP is a safe and effective method for the management of BPH, during which the strategies of avoiding blunt or sharp damage to the external urethral sphincter in the beginning, properly preserving the anterior lobe of the prostate in the middle and preserving the integrity of the bladder neck towards the end may help to achieve rapid recovery of urinary continence.


Subject(s)
Humans , Male , Organ Sparing Treatments , Methods , Postoperative Period , Prostatic Hyperplasia , General Surgery , Quality of Life , Transurethral Resection of Prostate , Methods , Treatment Outcome , Urethra , Urinary Bladder , Urinary Catheterization , Urinary Incontinence
17.
Arq. bras. med. vet. zootec. (Online) ; 69(6): 1551-1559, nov.-dez. 2017. ilus, graf
Article in Portuguese | LILACS (Americas), VETINDEX | ID: biblio-910563

ABSTRACT

O objetivo deste estudo foi utilizar a sonda uretral flexível como método alternativo para aferição da pressão intracraniana em coelhos com trauma cranioencefálico induzido pelo cateter de Fogarty 4 Fr (balão epidural) e comparar os dados obtidos com o método convencional de cateter de ventriculostomia. Foram utilizados 12 coelhos, machos, adultos, distribuídos aleatoriamente em dois grupos, denominados de G1: mensuração da PIC com cateter de ventriculostomia (n=6) e G2: mensuração com sonda uretral (n=6). Foram realizadas duas craniotomias na região parietal direita e esquerda para a implantação do cateter de ventriculostomia ou sonda uretral flexível e o balão epidural, respectivamente. A PAM, a PPC, a FC, a FR e a TR foram mensurados antes e após a craniotomia. A PIC foi avaliada após a craniotomia e a cada 10 minutos depois do preenchimento do balonete com 0,3mL de NaCl 0,9%, durante 40 minutos, e com 0,6mL, pelo mesmo período de tempo, totalizando 80 minutos. A PIC aumentou em ambos os grupos, sendo menores os valores registrados com a sonda uretral flexível. Foi possível reproduzir o aumento da PIC com o modelo experimental de TCE utilizando o cateter de Fogarty 4 Fr na região epidural e, embora haja a necessidade de outros estudos, a sonda uretral flexível demonstra ser um método alternativo de mensuração da PIC em coelhos com trauma cranioencefálico.(AU)


The aim of this study was to evaluate the use of flexible urethral catheter as an alternative method for measuring intracranial pressure in rabbits with head trauma induced by 4 F Fogarty catheter (epidural balloon) and compare the data obtained with the conventional method of ventriculostomy catheter. In this study, New Zealand rabbits were randomly distributed into two groups, G1: measuring the ICP with ventriculostomy catheter (n=6) and G2: measuring the ICP with urethral catheter (n=6). Two craniotomies were performed in the right and left parietal region for the implantation of a ventriculostomy catheter and/or flexible urethral catheter and epidural 4 Fr Fogarty arterial embolectomy catheter, respectively. MAP, CPP, HR, RF and RT values were measured before and after of the craniotomy. The ICP value was measured after craniotomy, every five minutes during 40 minutes after the balloon was inflated with 0.3 ml with NaCl and further 40 minutes after the balloon was inflated with 0.6 ml. The ICP value increased in both groups; however, the ICP values were lower in the flexible urethral catheter. The flexible urethral catheter can be used as an alternative method to measure ICP values in rabbits with head injury.(AU)


Subject(s)
Animals , Rabbits , Intracranial Pressure , Measurement Equipment , Urinary Catheterization/statistics & numerical data , Urinary Catheterization/veterinary , Craniocerebral Trauma/diagnosis , Ventriculostomy/veterinary
18.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 9(4): 1170-1176, out.-dez. 2017. tab
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-908503

ABSTRACT

Valorar os itens do custo direto do cateter vesical de demora (CVD) e realizar sua avaliação econômica parcial nos pacientes internados na Unidades de Terapia Intensiva (UTIs) com e sem infecções do trato urinário (ITU). Método: Trata-se de estudo descritivo do tipo série de casos, que utilizou a avaliação econômica parcial para estudar os custos diretos do cateterismo vesical de demora, analisando prontuários dos pacientes. Resultados: 48,45% do custo do CVD deve-se ao sistema coletor de urina, seguido do cloridrato de lidocaína (20,38%) e cateter Foley (12,70%). O aumento dos custos do CVD, associado ao tratamento da ITU, representa um aumento do custo em 18 vezes em ambas as UTIs, extrapolando o valor dos tratamentos em R$ 3.537.692,79, abrindo possibilidades para trabalhos de avaliação do custo-efetividade. Conclusão: A ITU associada ao CVD traz grande impacto no orçamento hospitalar, cabendo à análise econômica a alocação racional de recursos.


Urinary catheters (UC) are one of the most widely used invasive devices in intensive care units (ICUs), and its insertion is a major contributor to the development of complications, increasing hospitalization time and costs. Objectives: To evaluate the direct cost of UC and to carry out their partial economic evaluation in patients hospitalized in the ICU with and without UTI. Methods: Descriptive study, using partial economic evaluation by analyzing patients’ charts from a specific form. Results: 48.45% of the UC’s cost are due to the urine collection system, followed by lidocaine hydrochloride (20.38%) and Foley catheter (12.70%). The increase in UC’s costs, associated with UTI treatment, represent >18 times. By extrapolating the value of UTI’s treatments to the Brazilian healthcare system, the difference would be R$ 3,537,692.79. Conclusion: Catheter- associated UTI has a large impact on the hospital budget.


Los catéteres urinarios (CAU) son uno de los dispositivos invasivos más ampliamente utilizados en las unidades de cuidados intensivos (UCI), y su inserción es un importante contribuyente al desarrollo de complicaciones, hospitalización y costos. Objetivos: Evaluar el coste directo de la CAU y desarrollar una evaluación económica parcial em pacientes hospitalizados en la UCI con y sin infección del tracto urinario. Métodos: Estudio descriptivo mediante el análisis de los archivos de los pacientes. Resultados: 48,45% del costo de la UC se deben al sistema de recolección de orina, seguido de clorhidrato de lidocaína (20,38%) y el catéter de Foley (12,70%). El aumento de los costos de la CAU, associados con el tratamiento en la UCI representan >18 veces. Extrapolando el valor de los tratamientos UCI para el sistema de salud brasileño, la diferencia sería R$ 3,537,692.79. Conclusión: ITU asociada al catéter tiene un gran impacto en el presupuesto de hospital.


Subject(s)
Male , Female , Humans , Costs and Cost Analysis/statistics & numerical data , Economics/statistics & numerical data , Intensive Care Units , Urinary Catheterization/economics , Brazil
19.
Article in English | WPRIM (Western Pacific) | ID: wprim-633115

ABSTRACT

INTRODUCTION: Erythrocyte Sedimentation Rate (ESR) is an acute phase reactant and an indirect measure of inflammation inside the body. Transurethral electrosurgical Resection of the Prostate (TURP) is the current gold standard for management of patients with Benign Prostatic Hyperplasia (BPH) with moderate to severe lower urinary tract symptoms. The success of operation is determined when after resection of the prostate following removal of indwelling Foley catheter several days postoperative, the patient is able to avoid freely without catheter. It is not mentioned whether the edema of the postoperative site or the persistent inflammation of the prostate after resection may cause the failureof trial of voiding without catheter (TWOC).OBJECTIVE: The primary objective of this study was to determine if ESR can be a reliable predictor of success of in patients who underwent TURP for BPH.METHODS: On the day of planned catheter removal , 4 milliliters of blood was extracted from the patient, placed in an Ethylenediaminetetraacetic acid (EDTA) tube and sent to laboratory for ESR determination. One milliliterof EDTA-anticoagulated blood was placed in the Westergren tube. After 60 minutes, measurements were taken of the distance the red cells traveled to settle at the bottom of the tube. After catheter removal, patients were observed whether they can avoid freely without catheter or not. Patients who were not able to void within 4 to 6 hours were re-catheterized.RESULTS: From January 2015 to April 2016, 135 patients with BPH who underwent TURP in East Avenue Medical Center were included in the analysis. Success of trial voiding without catheter was observed in 117 of 135 patients (87%; p=0.000). Patients ages varied varied from 49 to 80 years, overall. Among these patients, the average ESR was significantly lower (48 mm versus 56 mm, range = 17-109 mm; p=0.012). Presence of urinary retention (61%), history of cigarette smoking (56%), hypertension (61%), diabetes mellitus (50%), trabeculations in cystoscopy and prostate size less than 20 grams (17%) were more common among patients with unsuccessful TWOC. ESR (p=0.012) was an independent significant predictor of TWOC. Based on univariate analysis, Diabetes Mellitus (DM) (p=0.003), trabeculations in cystoscopy (p=0.000) and UTI (p=0.000) were also significantlyassociated with TWOC. Among the significant independent covariates, DM was a significant factor affecting the success rate of TWOC (p=0.005) based on multivariate analysis. Patients without DM were about 16 times more likely to have a successful TWOC (OR=15.750, 95% CI=2.335, 106.227).CONCLUSION: Erythrocyte Sedimentation Rate was significantly lower in patients with success of trial voiding without catheter. ESR is a reliable predictor of success of TWOC in patients who underwent TURP for BPH.


Subject(s)
Humans , Male , Aged , Middle Aged , Adult , Urinary Retention , Prostatic Hyperplasia , Edetic Acid , Transurethral Resection of Prostate , Urinary Catheterization , Lower Urinary Tract Symptoms , Urination
20.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-643693

ABSTRACT

PURPOSE: The purpose of this study was to identify effects of self-evaluation using smartphone recording on competency in nursing skills, satisfaction and learning motivations in nursing students'. The setting was the open laboratory hours. METHODS: A quasi-experimental pre/post-test design was conducted in September 2015. The participants were 82 sophomore nursing students from one University. The experimental group did self-evaluation by watching recorded video clips of their performance. The control group did not have any self-evaluation. The primary outcomes were scores from the foley catheterization checklist, scores from a student satisfaction tool, and scores from a learning motivation tool. Data were analyzed using χ² test, Fisher's exact test, independent t-test, and paired t-test. RESULTS: There was a significant higher mean score in levels of satisfaction by students in the experimental group compared to the control group (t=2.26, p=.027). In addition, improvement in communication skills by the experimental group was significantly higher than improvement in the control group (t=3.96, p<.001). CONCLUSION: Findings show that self-evaluation using smartphone recordings has positive effects on increasing both communication skills and satisfaction with practice during open laboratory hours. These results indicate that, self-evaluation using smartphone recording is useful as a supplement to traditional open laboratory education.


Subject(s)
Checklist , Clinical Competence , Diagnostic Self Evaluation , Education , Humans , Learning , Motivation , Nursing , Personal Satisfaction , Self-Assessment , Smartphone , Students, Nursing , Urinary Catheterization
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