External Female Urinary Catheter: Implementation in the Emergency Department.

The emergency department is a care environment in which indwelling urinary catheters are placed frequently; however, the significance of the role of the emergency department in catheter-associated urinary tract infection prevention has been overlooked. The use of an external female urinary catheter is an alternative to placing an indwelling urinary catheter for female patients in the emergency department who are incontinent of urine or are immobile. The purpose was to describe the implementation of an initiative to decrease the number of indwelling urinary catheters and increase the use of external urinary female catheters in non-critically ill women who visited the emergency department at a 451-bed Magnet-designated community hospital in the Southeast. For this clinical implementation project, the Plan, Do, Check, Act framework was used to develop the initiative, and outcome data were collected retrospectively and included an indirect calculation of the number of indwelling urinary catheters placed in the emergency department. A total of 187 external catheters were used in place of indwelling catheters in female patients over a 3-month period. No skin irritation or breakdown was observed. This project demonstrated the initial staff acceptability and feasibility of external female urinary catheter use in the ED setting.

The Feasibility of Studying Fatigue Over Time in Patients on Hemodialysis: A Pilot Study and Lessons Learned.

This article describes an example of a pilot study that was done to determine the feasibility of measuring fatigue in patients on hemodialysis several times a day for one week to track patterns of fatigue. Pilot studies are studies done on a smaller scale that use the same methods and procedures to be used in a larger study and are important in determining the feasibility of a research project. Lessons learned regarding the feasibility of this pilot study are discussed, including difficulties in participant recruitment, retention, and data collection. Suggestions to improve feasibility of studying this topic in patients on hemodialysis are examined and highlight the importance of pilot studies in designing larger scale studies.

A Comparison of Temporal Patterns of Fatigue in Patients on Hemodialysis.

This qualitative study describes the temporal patterns of fatigue found as part of a larger study designed to elicit a description of the experience and self-management of fatigue for patients on hemodialysis. Two patterns of fatigue were identified. The first pattern, continuous fatigue, was characterized by participants who experienced fatigue at all times, which was their normal, baseline feeling. Within this group, two subgroups were identified. The second pattern of fatigue, post-dialysis fatigue only, was characterized by participants who experienced fatigue only after their hemodialysis session. This study is unique because it expands our knowledge about hemodialysis and fatigue by describing the patterns that fatigue follows over time from one hemodialysis session to the next. Insight into these phenomena could help ameliorate fatigue and allow nurses to tailor interventions for patients on hemodialysis.

The experience and self-management of fatigue in patients on hemodialysis.

Fatigue is a common and debilitating symptom for adult patients with end stage renal disease on hemodialysis, and has been associated with decreased survival and quality of life. Patients on hemodialysis must find ways to manage their fatigue and mitigate its effects on their lives. The purpose of this qualitative descriptive work was to describe the experience and self-management of fatigue in patients on incenter hemodialysis. Several themes were identified which included the nature of fatigue, management of fatigue, consequences of fatigue, and factors associated with fatigue. This information will be valuable to nephrology nurses as they continue to care for and educate patients on hemodialysis.

Fatigue in hemodialysis patients: a review of current knowledge.

CONTEXT: End-stage renal disease is a common chronic illness increasing in incidence and prevalence. Although kidney function is partially replaced through dialysis, patients endure many symptoms of the disease such as fatigue. Many factors have been studied regarding their relationship with fatigue in this population. OBJECTIVES: To provide a state of the science review regarding fatigue in hemodialysis patients by examining the experience of fatigue for patients on hemodialysis and correlates of fatigue in patients on hemodialysis. METHODS: PubMed, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Sociological Abstracts were searched using the key terms "fatigue," "dialysis," and "hemodialysis." Articles written after 1980 and those with explicit findings related to fatigue were included in this review. Articles that discussed fatigue in peritoneal dialysis patients or renal transplant patients were not included. RESULTS: There is little knowledge regarding the experience of fatigue for patients on hemodialysis and there has been little success identifying demographic, psychosocial, or physiological factors that are consistently related to fatigue. CONCLUSION: Further work in this area of inquiry would be of benefit and may shed light on the domains of life that are affected by fatigue for hemodialysis patients. It also may help deepen our knowledge regarding correlates that could identify hemodialysis patients who are at increased risk for fatigue.