Evidence Based Practice: Prevention of Post-Operative Urinary Retention after Uro-Gynecologic Surgery

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Hdl Handle:
http://hdl.handle.net/10755/163293
Category:
Abstract
Type:
Presentation
Title:
Evidence Based Practice: Prevention of Post-Operative Urinary Retention after Uro-Gynecologic Surgery
Author(s):
Buchko, Barbara L.; Robinson, Leslie; Douglass, Paul H.; Lawrence, John H.
Author Details:
Barbara L. Buchko, RN, MS, York Hospital, York, Pennsylvania, USA, email: bbuchko@wellspan.org; Leslie Robinson, MD; Paul H. Douglass, MD; John J. Lawrence, MD
Abstract:
Purpose: Urinary retention can be a significant problem post-operatively for women undergoing uro-gynecologic surgery. Bladder distention can lead to impaired bladder function, urinary tract infections and disruption of surgical repair with impaired surgical outcomes. The purpose of this study was to translate an evidence-based protocol for prevention of urinary retention in women who have undergone uro-gynecologic surgery (sub-urethral sling, Marshall-Marchetti-Krantz or Burch procedure, vaginal hysterectomy, and anterior and posterior colporrhaphy) in a community hospital setting. Theoretical Framework: The theoretical framework used for this study was the Johns Hopkins Nursing Evidence Based Practice Model. Methods (Design, Sample, Setting, Measures, Analysis): PUB med and CINAHL data bases were searched and 35 articles were reviewed including guidelines from the Royal College of Obstetricians and Gynecologist and American College of Obstetrics and Gynecology. Utilizing the best practices determined by the review, an algorithm was designed using clinical judgment (abdominal palpation) and ultrasound techniques (bladder scanner) to evaluate post voiding residual and voiding efficiency. Clinical nurses were educated on the use of the algorithm as well as physiology of the urinary tract, normal voiding function, post-operative voiding complications, techniques to monitor and diagnose malfunction of voiding process, how to measure for post void residual, and the concept of voiding efficiency and use of ultrasound technology for monitoring voiding function. A retrospective chart review was used to evaluate post void residual measurements, determine the number of catheterizations, length of time of Foley catheter was in-dwelling, and number of urinary tract infections pre and post implementation of the algorithm. Results: The audit is on-going but will be complete by the time of presentation. Conclusions and Implications: This project supports the use of best practice in the prevention of urinary retention and is an example that evidence supports clinical decision.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
19th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Providence, Rhode Island, USA
Description:
Conference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEvidence Based Practice: Prevention of Post-Operative Urinary Retention after Uro-Gynecologic Surgeryen_GB
dc.contributor.authorBuchko, Barbara L.en_US
dc.contributor.authorRobinson, Leslieen_US
dc.contributor.authorDouglass, Paul H.en_US
dc.contributor.authorLawrence, John H.en_US
dc.author.detailsBarbara L. Buchko, RN, MS, York Hospital, York, Pennsylvania, USA, email: bbuchko@wellspan.org; Leslie Robinson, MD; Paul H. Douglass, MD; John J. Lawrence, MDen_US
dc.identifier.urihttp://hdl.handle.net/10755/163293-
dc.description.abstractPurpose: Urinary retention can be a significant problem post-operatively for women undergoing uro-gynecologic surgery. Bladder distention can lead to impaired bladder function, urinary tract infections and disruption of surgical repair with impaired surgical outcomes. The purpose of this study was to translate an evidence-based protocol for prevention of urinary retention in women who have undergone uro-gynecologic surgery (sub-urethral sling, Marshall-Marchetti-Krantz or Burch procedure, vaginal hysterectomy, and anterior and posterior colporrhaphy) in a community hospital setting. Theoretical Framework: The theoretical framework used for this study was the Johns Hopkins Nursing Evidence Based Practice Model. Methods (Design, Sample, Setting, Measures, Analysis): PUB med and CINAHL data bases were searched and 35 articles were reviewed including guidelines from the Royal College of Obstetricians and Gynecologist and American College of Obstetrics and Gynecology. Utilizing the best practices determined by the review, an algorithm was designed using clinical judgment (abdominal palpation) and ultrasound techniques (bladder scanner) to evaluate post voiding residual and voiding efficiency. Clinical nurses were educated on the use of the algorithm as well as physiology of the urinary tract, normal voiding function, post-operative voiding complications, techniques to monitor and diagnose malfunction of voiding process, how to measure for post void residual, and the concept of voiding efficiency and use of ultrasound technology for monitoring voiding function. A retrospective chart review was used to evaluate post void residual measurements, determine the number of catheterizations, length of time of Foley catheter was in-dwelling, and number of urinary tract infections pre and post implementation of the algorithm. Results: The audit is on-going but will be complete by the time of presentation. Conclusions and Implications: This project supports the use of best practice in the prevention of urinary retention and is an example that evidence supports clinical decision.en_GB
dc.date.available2011-10-27T11:04:52Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:04:52Z-
dc.conference.date2007en_US
dc.conference.name19th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationProvidence, Rhode Island, USAen_US
dc.descriptionConference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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