Impact of portable volumetric ultrasound on bladder catheterizations due to urinary retention in an internal medicine unit
Abstract
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.
Downloads
References
Feneley RCL, Hopley IB, Wells PNT. Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol [Internet]. 2015 [cited 2019 Feb 19];39(8):459–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26383168
Metersky ML, Eldridge N, Wang Y, Mortensen EM, Meddings J. National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: Results from the Medicare Patient Safety Monitoring System. Am J Infect Control [Internet]. 2017 [cited 2019 Feb 18];45(8):901–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28625702
Iacovelli V, Gaziev G, Topazio L, Bove P, Vespasiani G, Agrò EF. Nosocomial Urinary Tract Infections: A Review. Urol J [Internet]. 2014 [cited 2019 Feb 19];81(4):222–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25451882
Jackson J, Davies P, Leggett N, Nugawela MD, Scott LJ, Leach V, et al. Systematic review of interventions for the prevention and treatment of postoperative urinary retention. BJS open [Internet]. 2019 [cited 2019 Feb 19];3(1):11–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30734011
Wang L-H, Tsai M-F, Han C-YS, Huang Y-C, Liu H-E. Is Bladder Training by Clamping Before Removal Necessary for Short-Term Indwelling Urinary Catheter Inpatient? A Systematic Review and Meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci) [Internet]. 2016 [cited 2017 Oct 24];10(3):173–81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27692245
Halawi MJ, Caminiti N, Cote MP, Lindsay AD, Williams VJ. The Most Significant Risk Factors for Urinary Retention in Fast-track Total Joint Arthroplasty are Iatrogenic. J Arthroplasty [Internet]. 2019 [cited 2019 Feb 19];34(1):136–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30268444
Serlin DC, Heidelbaugh JJ, Stoffel JT. Urinary Retention in Adults: Evaluation and Initial Management. Am Fam Physician [Internet]. 2018 [cited 2019 Feb 19];98(8):496–503. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30277739
Simonelli C, Mayer JW, Messner RP, Wright W. Measurement of critical bladder volume by b-mode ultrasound. Rocky Mt Med J [Internet]. 1979 [cited 2018 May 4];76(6):311. Available from: http://www.ncbi.nlm.nih.gov/pubmed/523899
Brunn J, Ruf G. Sonographische Zystometrie: Ein einfaches Verfahren zur Bestimmung des Restharns. DMW - Dtsch Medizinische Wochenschrift [Internet]. 1980 [cited 2018 May 4];105(43):1501–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7428656
Thanagumtorn K. Accuracy of Post-Void Residual Urine Volume Measurement Using an Ultrasound Bladder Scanner among Postoperative Radical Hysterectomy Patients. J Med Assoc Thai [Internet]. 2016 [cited 2019 Feb 19];99(10):1061–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29952185
Cho MK, Noh EJ, Kim CH. Accuracy and precision of a new portable ultrasound scanner, the Biocon-700, in residual urine volume measurement. Int Urogynecol J [Internet]. 2017 [cited 2019 Feb 19];28(7):1057–61. Available from: http://link.springer.com/10.1007/s00192-016-3224-0
Conway LJ, Pogorzelska M, Larson E, Stone PW. Adoption of policies to prevent catheter-associated urinary tract infections in United States intensive care units. Am J Infect Control [Internet]. 2012 [cited 2017 Apr 10];40(8):705–10. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0196655311012569
Daurat A, Choquet O, Bringuier S, Charbit J, Egan M, Capdevila X. Diagnosis of Postoperative Urinary Retention Using a Simplified Ultrasound Bladder Measurement. Anesth Analg [Internet]. 2015 [cited 2018 May 4];120(5):1033–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25642660
Alexaitis I, Broome B. Implementation of a Nurse-Driven Protocol to Prevent Catheter-Associated Urinary Tract Infections. J Nurs Care Qual [Internet]. 2014 [cited 2017 Apr 10];29(3):245–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24390382
D’Silva KA, Dahm P, Wong CL. Does This Man With Lower Urinary Tract Symptoms Have Bladder Outlet Obstruction? JAMA [Internet]. 2014 [cited 2018 May 4];312(5):535. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25096693
Baumann BM, McCans K, Stahmer SA, Leonard MB, Shults J, Holmes WC. Volumetric bladder ultrasound performed by trained nurses increases catheterization success in pediatric patients. Am J Emerg Med [Internet]. 2008 [cited 2017 Apr 10];26(1):18–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18082776
Cabezón Gil P, López Yepes L, Fernández Pérez C, Barreales Tolosa L, Montoya González P, López Timoneda F. Validez y fiabilidad de la ecografía vesical en la estimación no invasiva del volumen de orina en una Unidad de cirugía mayor ambulatoria. Rev Esp Anestesiol Reanim [Internet]. 2009;56(8):479–84. Available from: http://www.sciencedirect.com/science/article/pii/S0034935609704384
Rodrigo-Gil J, Suñer-Soler R, Cruz-Díaz V, Bagot-Prats M, Algans-Coll L, Cepeda-Bautista M, et al. [Care for patients with acute stroke: effectiveness of portable vesical ultrasound imaging in the stroke unit]. Rev Neurol [Internet]. 2012 [cited 2016 May 8];54(3):151–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22278891
Baumann BM, McCans K, Stahmer SA, Leonard MB, Shults J, Holmes WC. Caregiver and health care provider satisfaction with volumetric bladder ultrasound. Acad Emerg Med [Internet]. 2007 [cited 2017 Apr 10];14(10):903–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17898252
Institute JB. Removal of short-term indwelling urethral catheters. Nurs Stand. 2008;22(22):42–5.
Consellería de Sanidade, Xunta de Galicia E, Organización Panamericana de la Salud O-O, Universidad CES C. Epidat: programa para el análisis epidemiológico de datos. [Internet]. Santiago de Compostela: Xunta de Galicia; 2014. Available from: http://dxsp.sergas.es
Ley Orgánica 15/1999, de 13 de diciembre, de Protección de Datos de Carácter Personal. [Internet]. Madrid; 1999. Available from: https://www.boe.es/buscar/doc.php?id=BOE-A-1999-23750
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis [Internet]. 1987 [cited 2018 Aug 30];40(5):373–83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3558716
IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.
Frederickson M, Neitzel JJ, Miller EH, Reuter S, Graner T, Heller J. The implementation of bedside bladder ultrasound technology: effects on patient and cost postoperative outcomes in tertiary care. Orthop Nurs [Internet]. 2000 [cited 2017 Apr 10];19(3):79–87. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11153337
Palese A, Buchini S, Deroma L, Barbone F. The effectiveness of the ultrasound bladder scanner in reducing urinary tract infections: a meta-analysis. J Clin Nurs [Internet]. 2010 [cited 2019 Feb 19];19(21–22):2970–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21040003
Niel-Weise BS, van den Broek PJ, da Silva EM, Silva LA. Urinary catheter policies for long-term bladder drainage. Cochrane database Syst Rev. 2012;8:CD004201.
Medical Advisory Secretariat. Portable bladder ultrasound: an evidence-based analysis. Ont Health Technol Assess Ser [Internet]. 2006 [cited 2016 May 8];6(11):13. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3379524&tool=pmcentrez&rendertype=abstract
Golubovsky JL, Ilyas H, Chen J, Tanenbaum JE, Mroz TE, Steinmetz MP. Risk factors and associated complications for postoperative urinary retention after lumbar surgery for lumbar spinal stenosis. Spine J [Internet]. 2018 [cited 2018 May 4]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/29447854
Lee KS, Koo KC, Chung BH. Risk and Management of Postoperative Urinary Retention Following Spinal Surgery. Int Neurourol J [Internet]. 2017 [cited 2018 May 4];21(4):320–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29298471
Antonescu I, Baldini G, Watson D, Kaneva P, Fried GM, Khwaja K, et al. Impact of a bladder scan protocol on discharge efficiency within a care pathway for ambulatory inguinal herniorraphy. Surg Endosc [Internet]. 2013 [cited 2019 Feb 19];27(12):4711–20. Available from: http://link.springer.com/10.1007/s00464-013-3119-9
Chen S-C, Chen P-Y, Chen G-C, Chuang S-Y, Tzeng I-S, Lin S-K. Portable Bladder Ultrasound Reduces Incidence of Urinary Tract Infection and Shortens Hospital Length of Stay in Patients With Acute Ischemic Stroke. J Cardiovasc Nurs [Internet]. 2018 [cited 2019 Feb 19];33(6):551–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29851660
The works published in this magazine are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) preserves the copyright of the published works, and encourages and allows the reuse of the works under the license for use stated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2011 (© Publications Service, University of Murcia, 2011)
2. The works are published in the electronic edition of the journal under Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España(texto legal) “ a Attribution-NonCommercial-NoDerivatives 3.0 Spain license (legal text)”. They can be copied, used, broadcasted, transmitted and publicly displayed, provided that: i) the authorship and original source of their publication (journal, publisher and URL) are cited; (ii) are not used for commercial purposes; iii) the existence and specifications of this license is mentioned.
3. Conditions of self-archiving. Authors are allowed and encouraged to electronically disseminate the pre-print (pre-reviewed ) and / or post-print (reviewed and accepted for publication) versions of their works prior to publication, as it ensures a wider circulation and dissemination which may lead to a possible increase in its mention and a higher scope among the academic community. RoMEO color: green.
