2.50
Hdl Handle:
http://hdl.handle.net/10755/165019
Category:
Abstract
Type:
Presentation
Title:
CONTINUOUS BLADDER IRRIGATION FOR ONCOLOGY PATIENTS: A PROPOSED PROTOCOL
Author(s):
Johnson, Kristen; Thomas, Kristen; Douglas, Tracy
Author Details:
Kristen Johnson, RN, BSN, Nurse Clinician, Johns Hopkins Hospital, Baltimore, Maryland, USA, email: kjohns80@jhmi.edu; Kristen Thomas, RN, BSN; Tracy Douglas, RN, BSN, MSN
Abstract:
Hemorrhagic cystitis, inflammation of the bladder with hematuria, is a well recognized complication of bone marrow transplant resulting from infection or chemical insult to the bladder. Approximately 10 % of hematologic stem cell transplant patients develop hemorrhagic cystitis. Nurses in the oncology center have treated hemorrhagic cystitis with continuous bladder irrigation (CBI) for 20 years. The urology service provides consultation on these cases, but nursing expertise is most utilized without a standard of care for CBI. A standard CBI protocol would clarify nursing practice, increase nurse autonomy, clarify patient outcomes, and alleviate obstacles when educating new nurses on the management of CBI. Based on past standard of care at our institution and other hematologic stem cell transplant centers, literature reviews and expert medical and nursing opinions from oncology and urology, we developed a protocol for medical oncology patients having intermittent, partial, or complete urinary obstructions, related to blood clots in the bladder; or requiring the administration of intravesicular medication. Parameters for nursing assessments are outlined and include; color of urine, presence of clots, patency of flow, leaking around catheter, bladder distention, intake and output comparison, flow rate needed to maintain desired outflow color and patency of drainage system, vital signs, pain, daily weight, date of last stool, and interpretation of laboratory tests (hematocrit, platelet count, bacteria, white blood cells, JC virus, adenovirus, and BK virus). Nurses determine the frequency of assessments based on output color and system patency. Nurses have guidelines on interventions, which include, regulating infusion rate, flushing and irrigating the catheter, and holding the infusion. Detailed instructions for initiating, maintaining, and irrigating the system are included in the appendices. The protocol resides in the oncology center's online interdisciplinary clinical practice protocol manual. This protocol will be reviewed biannually through the Standards of Care Committee and evaluation of new nursesÆ management of CBI. The Standards of Care Committee approved the protocol. The protocol will standardize practice, improve patient outcomes, increase nurse autonomy, and improve the education of new nurses.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, 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.titleCONTINUOUS BLADDER IRRIGATION FOR ONCOLOGY PATIENTS: A PROPOSED PROTOCOLen_GB
dc.contributor.authorJohnson, Kristenen_US
dc.contributor.authorThomas, Kristenen_US
dc.contributor.authorDouglas, Tracyen_US
dc.author.detailsKristen Johnson, RN, BSN, Nurse Clinician, Johns Hopkins Hospital, Baltimore, Maryland, USA, email: kjohns80@jhmi.edu; Kristen Thomas, RN, BSN; Tracy Douglas, RN, BSN, MSNen_US
dc.identifier.urihttp://hdl.handle.net/10755/165019-
dc.description.abstractHemorrhagic cystitis, inflammation of the bladder with hematuria, is a well recognized complication of bone marrow transplant resulting from infection or chemical insult to the bladder. Approximately 10 % of hematologic stem cell transplant patients develop hemorrhagic cystitis. Nurses in the oncology center have treated hemorrhagic cystitis with continuous bladder irrigation (CBI) for 20 years. The urology service provides consultation on these cases, but nursing expertise is most utilized without a standard of care for CBI. A standard CBI protocol would clarify nursing practice, increase nurse autonomy, clarify patient outcomes, and alleviate obstacles when educating new nurses on the management of CBI. Based on past standard of care at our institution and other hematologic stem cell transplant centers, literature reviews and expert medical and nursing opinions from oncology and urology, we developed a protocol for medical oncology patients having intermittent, partial, or complete urinary obstructions, related to blood clots in the bladder; or requiring the administration of intravesicular medication. Parameters for nursing assessments are outlined and include; color of urine, presence of clots, patency of flow, leaking around catheter, bladder distention, intake and output comparison, flow rate needed to maintain desired outflow color and patency of drainage system, vital signs, pain, daily weight, date of last stool, and interpretation of laboratory tests (hematocrit, platelet count, bacteria, white blood cells, JC virus, adenovirus, and BK virus). Nurses determine the frequency of assessments based on output color and system patency. Nurses have guidelines on interventions, which include, regulating infusion rate, flushing and irrigating the catheter, and holding the infusion. Detailed instructions for initiating, maintaining, and irrigating the system are included in the appendices. The protocol resides in the oncology center's online interdisciplinary clinical practice protocol manual. This protocol will be reviewed biannually through the Standards of Care Committee and evaluation of new nursesÆ management of CBI. The Standards of Care Committee approved the protocol. The protocol will standardize practice, improve patient outcomes, increase nurse autonomy, and improve the education of new nurses.en_GB
dc.date.available2011-10-27T12:11:05Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:11:05Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, 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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