Intermittent catheterisation.

When an individual has voiding difficulties, the person may require a urinary catheter. Enabling the person to choose an appropriate method of catheterisation and supporting them can have an enormous impact on the individual's health and wellbeing. Indwelling urethral catheters are suitable for some people but for others they can affect a person's lifestyle and lead to depression. Intermittent catheterisation can work well for some people. Intermittent self-catheterisation has been used to manage urinary retention for over 3500 years. It remains the 'gold standard' in terms of bladder drainage, but it is under-used and indwelling catheters remain more common. This article examines the history of intermittent catheterisation, indications for self-catheterisation and how to support people to use self-catheterisation.

Acute urinary retention: patient investigations and treatments.

Acute urinary retention (AUR) is the sudden inability to pass urine. AUR is more common in men and older men are at highest risk. The most common causes are obstructive in nature-prostatic hyperplasia is responsible for more than half the cases of AUR in men. AUR can also be caused by infection, inflammation, and by iatrogenic and neurological problems. This article outlines how AUR is diagnosed and treated.

[Management of bladder retention in an elderly person]. / Prise en charge de la rétention vésicale chez une personne âgée.

A nurse clinician in urodynamics - advanced practice shares her experience in implementing self-bladder education sessions for bladder retention. The objective is to promote autonomy in the elderly person with bladder retention while developing collaborative work with the referring health care team to promote the transfer of knowledge. This requires a stance of listening and positive reinforcement in order to achieve a therapeutic collaboration with the patient and/or his or her entourage.

Impacto de la ecografía volumétrica portátil en el sondaje vesical por retención urinaria en una unidad de medicina interna / Impact of portable volumetric ultrasound on bladder catheterizations due to urinary retention in an internal medicine unit

OBJETIVO: Estimar el impacto que el uso de ecógrafo vesical tiene en los sondajes vesicales por sospecha de retención urinaria de una unidad de Medicina interna. METODOLOGÍA: Estudio de cohortes retrospectivas, comparando la cohorte expuesta a la disponibilidad del ecógrafo vesical, con la no expuesta el año previo. Se analizan todos los registros en la Historia Clínica Electrónica (HCE) de sondajes vesicales permanentes de corta duración en pacientes adultos que ingresaron en la unidad de hospitalización de Medicina Interna del Hospital Universitario Fundación Alcorcón (HUFA) durante los años 2015 y 2016. Se estima la frecuencia de retención urinaria como causa del sondaje después de la incorporación del dispositivo en la unidad y se compara con la frecuencia en sondajes durante el mismo periodo del año anterior en la misma unidad. Se estima el impacto que disponer de este dispositivo tiene en la frecuencia de retención urinaria como motivo del sondaje. RESULTADOS: Se incluyen 134 sondajes en 113 pacientes, 62 en el grupo sin ecógrafo y 72 en el grupo con ecógrafo. La frecuencia de sondajes por retención se reduce del 47.5% al 21.4% después de introducir el ecógrafo en la unidad. Esto supone una reducción del 50% (RR ajustado= 0.48; IC95%:0.27-0.84, p=0.01) en la frecuencia de sondaje vesical por sospecha de retención urinaria

AIM: To estimate the impact of the use of portable bladder volumetric ultrasound on bladder catheterization due to suspicion of urinary retention in an internal medicine unit. METHODOLOGY: Study of retrospective cohorts, comparing the cohort exposed to the availability of bladder ultrasound, with the not exposed the previous year. All records in the Electronic Medical Record (EHR) of short-term permanent bladder catheters in adult patients admitted to the Internal Medicine hospitalization unit of the University Hospital Fundación Alcorcón (HUFA) during the years 2015 and 2016 were analyzed. The urinary retention frequency is estimated as the cause of the catheterization after the device has been incorporated into the unit and compared with the frequency of catheterization during the same period of the previous year in the same unit. It is estimated that the impact of having this device on the urinary retention frequency is the reason for the catheterization. RESULTS: 134 catheters are included in 113 patients, 62 in the group without ultrasound and 72 in the group with ultrasound. The frequency of catheterizations due to retention is reduced from 47.5% to 21.4% after introducing the ultrasound unit into the unit. This represents a 50% reduction (adjusted RR=0.48; CI95%:0.27-0.84, p=0.01) in the frequency of urinary catheterization for suspected urinary retention

The effects of bladder training on bladder functions after transurethral resection of prostate.

AIM AND OBJECTIVES: The aim of this was to examine the effect of bladder training on bladder functions. BACKGROUND: Urinary catheterization is frequently performed in order to evaluate the outcomes of the surgical procedures and to monitor the urine output after urology operations. DESIGN AND METHODS: This quasi-experimental study was conducted in the urology clinic in Istanbul, Turkey in which 50 males were nonrandomly assigned to either a bladder training (n = 28) or a control group (n =22). In the bladder training groups, the urinary catheters of the patients were clamped at 4-hr intervals and then were left open for 5 min on the second postoperative day. This study was created in accordance with TREND Statement Checklist. RESULTS: The first urgency time and the first voiding time were longer, and the prevoiding and the voiding volumes were higher following the removal of the catheter in the training group (p = 0.001). In addition, the evaluation of the patient bladder diaries in the first three days after the discharge period revealed that the daily frequencies of micturition and nocturia were lower (p = 0.04), the mean duration of intervals between the micturition was longer (p = 0.006), and the mean voided urinary volume was higher (p = 0.024) in the training group. CONCLUSION: At the end of the study, it is observed that bladder training performed by clamping the catheter on postoperative day 2 after Transurethral Resection of Prostate (TUR-P) operation is a significant positive effect on the storage symptoms of the patients. RELEVANCE TO CLINICAL PRACTICE: Before removing the urinary catheter, bladder training programme affects positively to patients, especially prevoiding and the voiding volumes, the daily frequencies of micturition and nocturia on postoperative periods.

Selecting an intermittent self-catheter: key considerations.

This article explores the factors that must be considered when assessing patients for intermittent self-catherisation (ISC). It discusses the various types of intermittent catheters and their properties. Key considerations for the health professional when making product recommendations are covered and emphasis is placed on teaching patients the ISC technique. The article also highlights what patients value in terms of product choice and the importance of ongoing support. It concludes by introducing the GentleCath Glide, a new product that incorporates FeelClean™ technology, which leaves less residue on the hands and clothes.

How intermittent self-catheterisation can promote independence, quality of life and wellbeing.

Intermittent catheterisation is considered the gold standard for bladder drainage. This article describes intermittent self-catheterisation (ISC) and which patients are likely to benefit from it. Before deciding on a patient's suitability for ISC, health professionals should carry out a full assessment and ensure the patient and/or carers are taught the skills necessary to perform the procedure. ISC enables patients to be more independent because they can choose how often and where to undertake it, which encourages adherence. The range of products is vast; the nurse can guide patients to select the catheter most suited to their individual needs.

Low incidence of postoperative urinary retention with the use of a nurse-led bladder scan protocol after hip and knee arthroplasty: a retrospective cohort study.

PURPOSE: Postoperative urinary retention (POUR), defined as the inability to empty the bladder voluntary after surgery, is a commonly reported complication. This study reports the incidence and possible risk factors for POUR after elective fast-track hip or knee arthroplasty when using a nurse-led bladder scan protocol. METHODS: This retrospective cohort study included data from 803 patients who underwent unilateral hip or knee arthroplasty. Patients' digital clinical records were reviewed for eligibility. Patients with incomplete data registration, preoperative bladder volume >250 ml, preexisting bladder catheterization, and/or patients following the outpatient pathway were excluded. Bladder volumes were assessed at different moments pre- and postoperatively. The outcome was the incidence of POUR, defined as the inability to void spontaneously with a bladder volume >600 ml, treated with indwelling catheterization. Further analysis between POUR and non-POUR patients was performed to detect possible risk factors for POUR. RESULTS: Six hundred and thirty-eight patients operated on primary unilateral hip or knee arthroplasty were analyzed. The incidence of POUR was 12.9% (n = 82, 95% CI 9.4-15.5). Gender, age, BMI, ASA classification, preoperative bladder volume, type of anesthesia, type of arthroplasty, and perioperative fluid administration were not significant different between POUR and non-POUR patients. Patients with a bladder volume of >200 ml at the recovery room were at higher risk (OR 5.049, 95% CI 2.815-9.054) for POUR. CONCLUSIONS: When using a nurse-led bladder scan protocol in fast-track hip and knee arthroplasty, the incidence of POUR was 12.9%, with a bladder volume of >200 ml at the recovery room as a risk factor for POUR. LEVEL OF EVIDENCE: A retrospective cohort study, Level III.

Meeting the Needs of the Complex Older Adult Patient with Urinary Retention: A Case Study.

This article presents a case study of how a homebound older adult patient with urinary retention is managed by a patient-centered medical home/transitional care model. A description of how a root cause analysis can effectively improve outcomes is also provided.

Urinary retention: implications of low-fidelity simulation training on the self-confidence of nurses.

METHOD: This was a quasi-experimental study carried out among nurses stationed in municipal care units in the interior of São Paulo State. Data were collected during the course of a pedagogical workshop that used low-fidelity simulation training. RESULTS: The study included 42 nurses, mostly female with over 15 years of experience. After low-fidelity simulation training, nurses showed a significant increase (p<0.05) in confidence related to nursing care in urinary retention. The lowest self-attributed scores during the activity were related to the objective assessment of urinary retention. CONCLUSION: Low-fidelity simulated training is an effective resource for the development of nurses with respect to nursing care in urinary retention. OBJETIVO: Avaliar o nível de autoconfiança de enfermeiros na assistência de enfermagem na retenção urinária antes e após atividade simulada de baixa fidelidade. MÉTODO: Estudo quase-experimental realizado junto aos enfermeiros lotados nas unidades de atendimento de município do interior do estado de São Paulo. Os dados foram coletados durante a realização de uma oficina pedagógica que contou com atividade simulada de baixa fidelidade. RESULTADOS: Participaram do estudo 42 enfermeiros, a maioria do sexo feminino e com mais de 15 anos de atuação. Após o treino simulado de baixa fidelidade os enfermeiros demonstraram aumento significativo (p < 0,05) na autoconfiança relacionada à assistência de enfermagem na retenção urinária. Os menores escores autoatribuídos durante a atividade foram relacionados à avaliação objetiva da retenção urinária. CONCLUSÃO: A simulação de baixa fidelidade é um recurso efetivo no aprimoramento de enfermeiros no que diz respeito à assistência de enfermagem na retenção urinária.

Urinary retention: implications of low-fidelity simulation training on the self-confidence of nurses / Retención urinaria: implicaciones del entrenamiento simulado de baja fidelidad en la autoconfianza del enfermero / Retenção urinária: implicações do treino simulado de baixa fidelidade na autoconfiança do enfermeiro

Abstract OBJECTIVETo evaluate the confidence level of nurses in nursing care in urinary retention before and after low-fidelity simulation training. METHOD This was a quasi-experimental study carried out among nurses stationed in municipal care units in the interior of São Paulo State. Data were collected during the course of a pedagogical workshop that used low-fidelity simulation training. RESULTS The study included 42 nurses, mostly female with over 15 years of experience. After low-fidelity simulation training, nurses showed a significant increase (p<0.05) in confidence related to nursing care in urinary retention. The lowest self-attributed scores during the activity were related to the objective assessment of urinary retention. CONCLUSION Low-fidelity simulated training is an effective resource for the development of nurses with respect to nursing care in urinary retention.

Resumen OBJETIVO Evaluar el nivel de autoconfianza de enfermeros en la asistencia de enfermería en la retención urinaria antes y después de actividad simulada de baja fidelidad. MÉTODO Estudio cuasi-experimental realizado junto a los enfermeros ubicados en las unidades de atención de municipio del interior del Estado de São Paulo. Los datos fueron recolectados durante la realización de un taller pedagógico que contó con actividad simulada de baja fidelidad. RESULTADOS Participaron en el estudio 42 enfermeros, la mayoría del sexo femenino y con más de 15 años de actuación. Después del entrenamiento simulado de baja fidelidad, los enfermeros demostraron aumento significativo (p < 0,05) en la autoconfianza relacionada con la asistencia de enfermería en la retención urinaria. Los menores puntajes autoatribuidos durante la actividad estuvieron relacionados con la evaluación objetiva de la retención urinaria. CONCLUSIÓN La simulación de baja fidelidad es un recurso efectivo en el perfeccionamiento de enfermeros en lo que se refiere a la asistencia de enfermería en la retención urinaria.

Resumo OBJETIVO Avaliar o nível de autoconfiança de enfermeiros na assistência de enfermagem na retenção urinária antes e após atividade simulada de baixa fidelidade. MÉTODO Estudo quase-experimental realizado junto aos enfermeiros lotados nas unidades de atendimento de município do interior do estado de São Paulo. Os dados foram coletados durante a realização de uma oficina pedagógica que contou com atividade simulada de baixa fidelidade. RESULTADOS Participaram do estudo 42 enfermeiros, a maioria do sexo feminino e com mais de 15 anos de atuação. Após o treino simulado de baixa fidelidade os enfermeiros demonstraram aumento significativo (p < 0,05) na autoconfiança relacionada à assistência de enfermagem na retenção urinária. Os menores escores autoatribuídos durante a atividade foram relacionados à avaliação objetiva da retenção urinária. CONCLUSÃO A simulação de baixa fidelidade é um recurso efetivo no aprimoramento de enfermeiros no que diz respeito à assistência de enfermagem na retenção urinária.

A Clinical Nurse Specialist-Directed Initiative to Reduce Postoperative Urinary Retention in Spinal Surgery Patients.

: Postoperative urinary retention (POUR) is the inability to void when the bladder is full after surgery. It is a common complication in postoperative patients, especially in patients undergoing spinal surgery. At our institution, patients who were discharged from the postanesthesia care unit (PACU) to the inpatient surgical unit typically had bladder distention and a bladder volume of more than 450 mL. In an effort to address this situation, an interprofessional group of advanced practice RNs and physicians formed a team, reviewed the existing literature, examined the PACU nursing practice guideline for evaluating and managing POUR, and devised a quality improvement (QI) project to raise the PACU nursing staff's awareness of the potential for POUR among postoperative patients and to develop an updated nursing practice algorithm for the evaluation and management of POUR in spinal surgery patients. A description of the QI process, including the revised algorithm and pre- and postintervention results, is reported here. In the preintervention group (n = 42), 19 indwelling urinary catheterizations were documented in patient records; no use of intermittent catheterization was documented. In the postintervention group (n = 43), seven indwelling urinary catheterizations were documented in patient records; the use of intermittent catheterization was documented in 11. As a result of our intervention, we decreased the number of indwelling urinary catheters inserted in the PACU, and supported the PACU nursing staff in more frequent and appropriate use of intermittent catheterization in patients undergoing spinal surgery.

Usability Assessment of Moodle by Brazilian and Portuguese Nursing Students.

Distance education has turned into an important tool for nursing education. The virtual learning environments contribute toward an interactive and attractive educational process. In this study, we assess the usability of a virtual learning environment that was developed to teach nursing students how to care for patients with urinary retention. A multicenter and descriptive study was undertaken, which involved nursing students from the University of São Paulo at Ribeirão Preto College of Nursing, Brazil, and the Escola Superior de Enfermagem de Coimbra, Portugal. The participants were 79 students, mostly female, between 20 and 24 years of age. The virtual learning environment revealed good properties in terms of usability on most criteria. Future research will help to confirm the results.

Validation of the self-confidence scale of nursing care in urinary retention.

OBJECTIVE: to validate an instrument to measure self-confidence of nursing care in urinary retention. METHODS: methodological research study, carried out after ethical approval. A Likert-like scale of 32 items related to nursing care in urinary retention was applied to students of the graduate nursing course. For instrument validation, analysis of the sample adequacy and main components, Varimax orthogonal rotation and internal consistency analyses were developed. RESULTS: in a sample of 305 students, there was high correlation of all items with the total scale and Cronbach's alpha of 0.949. The scale items were divided into five factors with internal consistency: Factor 1 (0.890), Factor 2 (0.874), Factor 3 (0.868), Factor 4 (0.814) and Factor 5 (0.773), respectively. CONCLUSION: the scale meets the validity requirements, demonstrating potential for use in evaluation and research.

Validation of the self-confidence scale of nursing care in urinary retention / Validação de escala de autoconfiança para assistência de enfermagem na retenção urinária / Validación de escala de autoconfianza para asistencia de enfermería en la retención urinaria

Objective: to validate an instrument to measure self-confidence of nursing care in urinary retention.Methods: methodological research study, carried out after ethical approval. A Likert-like scale of 32 items related to nursing care in urinary retention was applied to students of the graduate nursing course. For instrument validation, analysis of the sample adequacy and main components, Varimax orthogonal rotation and internal consistency analyses were developed.Results: in a sample of 305 students, there was high correlation of all items with the total scale and Cronbach's alpha of 0.949. The scale items were divided into five factors with internal consistency: Factor 1 (0.890), Factor 2 (0.874), Factor 3 (0.868), Factor 4 (0.814) and Factor 5 (0.773), respectively.Conclusion: the scale meets the validity requirements, demonstrating potential for use in evaluation and research.

Objetivo: validar instrumento para mensurar a autoconfiança na assistência de enfermagem na retenção urinária.Métodos: estudo de investigação metodológica, realizado após autorização ética. Foi aplicada a estudantes do Curso de Graduação em Enfermagem uma escala tipo Likert, de 32 itens, referentes à assistência de enfermagem na retenção urinária. Para a validação do instrumento, foi realizada análise da adequação amostral e dos componentes principais, rotação ortogonal Varimax e consistência interna.Resultados: numa amostra de 305 estudantes, houve elevada correlação de todos os itens com o total da escala, alpha de Cronbach 0,949. Os itens da escala foram divididos em: cinco fatores, com consistência interna de: Fator 1 (0,890), Fator 2 (0,874), Fator 3 (0,868), Fator 4 (0,814) e Fator 5 (0,773), respectivamente.Conclusão: a escala cumpre os requisitos de validade, demonstrando potencial para uso em avaliação e investigação.

Objetivo: validar un instrumento para medir la autoconfianza en la asistencia de enfermería en la retención urinaria.Métodos: estudio de investigación metodológica, realizado después de recibir autorización ética. Fue aplicado a estudiantes del Curso de Graduación en Enfermería una escala tipo Likert, de 32 ítems, referentes a la asistencia de enfermería en la retención urinaria. Para la validación del instrumento, fue realizado: análisis de la adecuación del muestreo y de los componentes principales, rotación ortogonal Varimax y verificación de consistencia interna.Resultados: en una muestra de 305 estudiantes, hubo elevada correlación de todos los ítems con el total de la escala, Alpha de Cronbach 0,949. Los ítems de la escala fueron divididos en cinco factores, con consistencia interna de: Factor 1 (0,890), Factor 2 (0,874), Factor 3 (0,868), Factor 4 (0,814) y Factor 5 (0,773).Conclusión: la escala cumple los requisitos de validez, demostrando potencial para ser usada en evaluación e investigación.