Catheterisation: best practice in bladder care.

Bladder care is an integral part of caring for a woman in labour and the immediate postpartum period (National Institute for Health and Care Excellence (NICE) 2014a). To ensure effective bladder care, the skill of urinary catheterisation is often undertaken by a midwife and can be required in a variety of different situations. Catheterisation is a necessary intervention whether it is intermittent, indwelling, short-term or, less often, long-term. This article addresses the current recommended guidance, highlights best practice measures and provides useful hints and tips to support catheter care.

Adolescents' experience with scoliosis surgery: a qualitative study.

This article reports a study of adolescents' narrated experiences of undergoing scoliosis surgery. Six adolescents were interviewed. Open and semistructured questions were asked, and a qualitative content analysis of the text was performed. The results are presented in three main categories followed by subcategories. The three main categories of experience were emotional, physical, and social. The emotional aspects that emerged were fear, nightmares, nervousness, and helplessness. These had a great impact on adolescents' well-being before, during, and after the hospital visit. The physical aspects were mobilization, scars, different hip levels, pain, nausea, appetite, and urinary catheter. These aspects caused much discomfort, mostly during the hospital visit. The social aspects were friends, power, coaching and comfort, and sports. Some of the social aspects had a strong negative impact on the adolescents' well-being mostly after the hospital visit. This study suggests that both before and long after the surgery adolescents have strong emotions that they should be better prepared and helped to manage. To optimize perioperative care an interdisciplinary, a holistic approach must be taken that incorporates the complexity and whole of the adolescent's experiences. The findings of this study suggest that perioperative care of adolescents during scoliosis surgery needs to be optimized. To improve patients' psychologic preparation before surgery pediatric nurses should learn more about the individual patient and make care plans from a holistic perspective. Follow-up after discharge should address emotional, social, and physical aspects of the adolescent's health.

Learning through authentic assessment: an evaluation of a new development in the undergraduate midwifery curriculum.

Assessment is a powerful influence on learning, and can form an important strategy amongst a variety of teaching and learning approaches. Authentic assessment activities are designed to mimic the complexity of 'real world' situations that students may encounter in professional life, and require the application of a combination of skills related to knowledge, skills and attitude. We undertook a small-scale evaluation using a qualitative descriptive design to explore the feasibility and usefulness of an authentic assessment item that focused on a common clinical scenario in midwifery practice, female catheterisation. Seven third year Bachelor of Midwifery students and three teaching staff volunteered to participate in the project. During the process the students videoed the scenario for peer assessment, developed marking criteria, completed an online survey and participated in a focus group. The findings demonstrated that the students' confidence, knowledge and skills improved as a result of participating in the assessment item and they rated it positively for use in the Bachelor of Midwifery curriculum as a means of increasing real world assessment activities. It is anticipated that this learning strategy will be further refined and integrated in various ways into other clinical midwifery subjects in the midwifery curriculum.

Exploring urinary catheters: the perspectives of patients and nurses.

This literature review is part of a larger dissertation project that explores the lived experience of patients using long-term urinary catheters and nurses' attitudes towards urinary catheters. Systematic examination of the literature revealed six relevant primary research studies. These were critically appraised to assess their worth. Further studies were also reviewed, although these were often from neighbouring fields as relatively little research has been undertaken in this field. Findings suggest that there is a disparity between the care that nurses provide to patients with long-term catheters and the holistic care that patients need. Furthermore, nurses' decision-making skills are hampered by poor multidisciplinary documentation practices in the acute sector. It is concluded that nurses' attitudes towards urinary catheters do affect the care that patients receive.

Female bladder catheterisation: step by step.

Catheterisation of the female urinary bladder is performed by midwives for a range of reasons. This article outlines and the main reasons for this procedure, including during labour and after the birth. It describes the equipment needed and the procedure undertaken, summarising the aseptic technique required to minimise the risk of urinary tract infection. The use of anaesthetic gels to minimise pain and trauma is considered. The article highlights the potentially embarrassing nature of catheterisation for women and urges midwives to perform this skill with maximum dexterity and minimum fuss.

Offering patients a choice of urinary catheter drainage system.

The aim of this article is to promote understanding of the benefits, assessment process and suitability of catheter valves, as a form of urinary drainage for patients. A literature review on the benefits of catheter valves provides the opportunity for an in-depth discussion that compares and contrasts different urinary drainage systems. On the evidence of the literature review, all patients require a holistic assessment which considers a number of factors, and provides the nurse with the essential objective data to ascertain the suitability of the catheter valve. These data can be transferred into an easy step-by-step algorithm to help guide the nurse in making the decision, with the patient, on the most appropriate urinary catheter drainage system.

The high impact actions for nursing and midwifery 5: protection from infection.

Four out of every five urinary tract infections can be traced to indwellng catheters. If the number of these infections is to be reduced significantly, nurses need to implement best practice for catheter care, and only catheterise patients when absolutely necessary.

Clinical faculty development: using simulation to demonstrate and practice clinical teaching.

Students spend more time in clinical settings with smaller student-to-faculty learning ratios than in the didactic setting, yet many clinical faculty have had little exposure to evidence-based teaching strategies and learning theories. Orientation for newly employed clinical faculty, whether novices or experienced teachers, typically focuses on the details of running the clinical experience and not on teaching and learning. Multiple barriers for clinical faculty limit the ability to provide consistent and comprehensive education. The purpose of this article is to share the use of simulation as a strategy to prepare and support clinical faculty in their teaching role.

Water versus antiseptic periurethral cleansing before catheterization among home care patients: a randomized controlled trial.

BACKGROUND: There is a lack of research studies on periurethral cleansing before catheterization among home care patients. The purpose of this study was to compare the risk of acquiring symptomatic urinary tract infections through the conventional practice of using 0.05% chlorhexidine gluconate (CHG) versus sterile water for periurethral cleansing before insertion of an indwelling urinary catheter. METHODS: A randomized controlled trial was used, and subjects were randomly allocated to either the sterile water group or the 0.05% CHG group. Urine specimens for culture were collected 4 times for each subject within 2 weeks. RESULTS: Seventy-four urine samples were collected in 20 subjects (sterile water group, 8; 0.05% CHG group, 12). There was no significant difference in colonization count between the 2 groups. In addition, none of the subjects in the 2 groups developed symptomatic bacteriuria. CONCLUSION: Using sterile water to clean the periurethral area before catheterization among home care patients will not increase the risk for urinary tract infections.

Creation of a registered nurse-administered nitrous oxide sedation program for radiology and beyond.

Children undergoing urethral catheterization for urologic imaging under existing sedation practices were identified as an underserved patient population. Using a multidisciplinary approach, a registered nurse (RN)-administered nitrous oxide sedation program was developed to meet the needs of these children. Program development required delineation of RN scope of practice, evaluation of equipment, formulation of an educational program, and compliance with occupational safety standards. The program was implemented in 2004 using standard "dental" nitrous oxide equipment coupled with distraction and imagery to enhance the efficacy of the sedation experience. Initial assessment via telephone questionnaire indicated fewer adverse effects and more rapid return to baseline than oral midazolam, the sedative previously used for these procedures. Ongoing evaluation continues to confirm patient and environmental safety. The nitrous oxide program has expanded to provide sedation for additional tests in radiology as well as in other hospital departments. By implementing an RN-administered nitrous oxide program, children's access to this sedative/analgesic agent is increased.

Teaching children and young people intermittent self-catheterization.

The need to catheterize through the urethra can begin at any age and stage of development in a child's life and may involve different strategies for teaching. Intermittent self-catheterization, as a self-management technique, can be of benefit both physically and psychologically to children and young people. Educational strategies are available to aid health care providers in teaching children and young people self-intermittent catheterization. Use of innovative techniques and resources may assist the practitioner in teaching self-catheterization successfully to this challenging population.

[Study on prevention of catheter associated urinary tract infection by using JUS long-acting antibacterial material].

OBJECTIVE: To observe the effect of reducing the incidence of CAUTI by spraying the long-acting antibacterial material JUS on the surface of catheter and urethral orifice. METHODS: Sixty male patients, aged from 68 to 79, with indwelling catheter after TURP were divided randomly into two groups (control group and treated group), each consisting of 30 patients. For the control group, their urethral orifice was treated conventionally twice a day; while for the treated group, in addition to the conventional treatment of their urethral orifice, the catheter and their urethral orifice were sprayed with the long-acting antibacterial material JUS twice a day. RESULT: The number of cases of urinary tract infection in the treated group during catheterization was evidently less than those of the control group (P < 0.01), so the difference was of remarkable significance. CONCLUSION: The long-acting antibacterial material, after spraying on the wall of catheter and urethral orifice of the patients with indwelling catheter, may form a layer of physically antibacterial molecular film to prevent the formation of a bacterial biological film and effectively reduce the incidence of CAUTI.

Reflective, holistic care after radical penectomy.

This case study describes the management of a patient with complex problems by a urology nurse specialist. Penile amputation and the creation of a colostomy had a severe impact on body image so the patient's care required a holistic approach. He also needed the support of community nurses, and collaboration between them and the urology nurse specialist prevented fragmentation of his care in the end stages of his life.

Assessment and intervention knowledge of nurses in managing catheter patency in continuous bladder irrigation following TURP.

Continuous bladder irrigation (CBI) is an established procedure designed to prevent the formation and retention of blood clots following transurethral prostatectomy (TURP). The purpose of this study was to evaluate a tool designed to determine what steps the nurse should follow to assess whether a catheter is blocked and the actions to be taken to restore catheter patency for CBI.

Improving community catheter management.

A poorly managed indwelling urethral catheter can significantly reduce quality of life. The formulation of a community catheter management policy led to the development of standards encouraging a proactive, holistic approach to care.

Nursing interventions for urinary incontinence in home health.

Urinary incontinence (UI) is a significant health care issue among older patients in the acute care, extended care, and home care settings. With the shift toward health care delivery in the home setting, it is becoming increasingly necessary for home health care professionals to become knowledgeable about the causes, assessment, and treatment. This article will review the epidemiology, causes, assessment, and management of UI in the home care setting. Emphasis is placed on the role of the WOC nurse as coordinator of a multidisciplinary team providing care of the home bound patient with UI.

The efficacy of nursing education as an intervention in the treatment of recurrent urinary tract infections in individuals with spinal cord injury.

Urinary tract infection (UTI) continues to be the most frequent secondary medical complication experienced by persons with spinal cord injury (SCI). We developed a carepath designed to minimize recurrent UTIs in patients identified as at risk. Data were collected in a prospective fashion for 1,000 consecutive days at an outpatient SCI clinic. The number of UTIs decreased to below threshold in 65 percent of the patients when the nurse clinician counseled them regarding proper technique and hygiene related to clean intermittent catheterization. Of the patients who responded to this intervention, 73 percent required multiple counseling sessions. We conclude that educational intervention by a clinic nurse is a simple, cost-effective means of decreasing the risk of UTIs in individuals with SCI who are identified as at risk.

Patient management following suprapubic catheterization.

This article considers the issue of suprapubic catheterization and the subsequent care of the client. The conditions and situations where suprapubic catheterization may be used are outlined. A review of the literature on this important subject suggests that there is little research/evidence-based practice to support some current-day practices. The review addresses such issues as what suprapubic catheterization is and how it is carried out. Key issues such as avoidance of infection, the need for dressings and care of the insertion site are discussed. In particular, the gynaecological field is explored to highlight concern about variations and discrepancies in approaches to care of the patient with a suprapubic catheter in situ. Finally, a call is made for practitioners to base their care on research findings or evidence-based practice rather than tradition, ritual or heresy.