2.50
Hdl Handle:
http://hdl.handle.net/10755/163670
Category:
Abstract
Type:
Presentation
Title:
Empowering nurses to treat urinary retention using medical management guidelines
Author(s):
Matula, Patricia
Author Details:
Patricia Matula, Lehigh Valley Hospital, Allentown, Pennsylvania, USA, email: patricia.matula@lvh.com
Abstract:
Foley catheter indwelling time is directly correlated to higher risk of nosocomial urinary tract infection (UTI). Nosocomial UTI: accounts for increased morbidity and mortality, increased length of stay and cost. Eighty to ninety percent of nosocomial UTI's are due to the use of indwelling catheters. This number approaches 95% in the intensive care population. Catheterization carries a 3 to10% incidence of bacteriuria per day of dwell time, and a 1 to 2% risk of infection. In November 1999, Lehigh Valley Hospital, a 750-bed multi-site acute care institution, studied quality data to determine the scope of nosocomial UTI. Based on the findings, a multidisciplinary task force was formed to study cause and develop and implement action plans. An extensive review of the literature demonstrated that intermittent catheterization, rather than placement of indwelling catheters, significantly reduced risk of UTI: yet, a survey revealed that many physicians and nurses believed the opposite. Medical management guidelines, using an algorithmic format and evidence-based research, were developed to allow nurses to treat urinary retention via intermittent catheterization, without a physician order. The basis for the guidelines was integration of bladder scan technology to assess whether a patient's anuria was due to retention rather than another cause. Prior to implementation of the guidelines, four pilot patient care units were selected. Indwelling catheter time, indwelling catheter utilization and UTI: rates were measured and calculated. These same data elements were then measured post-implementation. Analysis indicated that indwelling catheter use on the four pilot units was minimized, leading to lower infection rates. As important, the guidelines have empowered nurses to make medical management decisions for their patients without resorting to physician intervention. This has resulted in improved time efficiencies and increased staff satisfaction. The study is currently being implemented throughout the house, beyond the four pilot units.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
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.titleEmpowering nurses to treat urinary retention using medical management guidelinesen_GB
dc.contributor.authorMatula, Patriciaen_US
dc.author.detailsPatricia Matula, Lehigh Valley Hospital, Allentown, Pennsylvania, USA, email: patricia.matula@lvh.comen_US
dc.identifier.urihttp://hdl.handle.net/10755/163670-
dc.description.abstractFoley catheter indwelling time is directly correlated to higher risk of nosocomial urinary tract infection (UTI). Nosocomial UTI: accounts for increased morbidity and mortality, increased length of stay and cost. Eighty to ninety percent of nosocomial UTI's are due to the use of indwelling catheters. This number approaches 95% in the intensive care population. Catheterization carries a 3 to10% incidence of bacteriuria per day of dwell time, and a 1 to 2% risk of infection. In November 1999, Lehigh Valley Hospital, a 750-bed multi-site acute care institution, studied quality data to determine the scope of nosocomial UTI. Based on the findings, a multidisciplinary task force was formed to study cause and develop and implement action plans. An extensive review of the literature demonstrated that intermittent catheterization, rather than placement of indwelling catheters, significantly reduced risk of UTI: yet, a survey revealed that many physicians and nurses believed the opposite. Medical management guidelines, using an algorithmic format and evidence-based research, were developed to allow nurses to treat urinary retention via intermittent catheterization, without a physician order. The basis for the guidelines was integration of bladder scan technology to assess whether a patient's anuria was due to retention rather than another cause. Prior to implementation of the guidelines, four pilot patient care units were selected. Indwelling catheter time, indwelling catheter utilization and UTI: rates were measured and calculated. These same data elements were then measured post-implementation. Analysis indicated that indwelling catheter use on the four pilot units was minimized, leading to lower infection rates. As important, the guidelines have empowered nurses to make medical management decisions for their patients without resorting to physician intervention. This has resulted in improved time efficiencies and increased staff satisfaction. The study is currently being implemented throughout the house, beyond the four pilot units.en_GB
dc.date.available2011-10-27T11:11:42Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:11:42Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_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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