BACKGROUND Urologists are commonly consulted regarding difficult and traumatic urethral catheterizations.Complications surrounding Foley catheterizations represent a significant burden to the healthcare system.AIM To ...BACKGROUND Urologists are commonly consulted regarding difficult and traumatic urethral catheterizations.Complications surrounding Foley catheterizations represent a significant burden to the healthcare system.AIM To assess the demographic and patient characteristics surrounding urological consultation for difficult and traumatic Foley catheterizations at our institution across multiple hospitals.METHODS This is a single-institution,multi-hospital,263 patient,retrospective chart review from Jan 2020–December 2023.RESULTS The majority of consultations(80.2%)did not require heroic measures by the urology service.A Foley catheter placement was determined not difficult in the majority 191(72.6%)of patients.Sub-group analysis of“difficult by urology”vs“not difficult by urology”,showed a significant difference between those with zero attempts,one attempt,and greater than one attempts(P=0.004).Those patients specifically with greater than one attempts were more likely to be seen as a difficult insertion by urology assessment(60.6%)compared to not difficult(38.6%).Likewise,those patients with a history of difficult urethral catheter(DUC)/traumatic urethral catheterization(TUC)(25.8%)were more likely to be difficult compared to those without a history of DUC/TUC(14.2%)(P=0.038).CONCLUSION The study found that majority of consultations received did not require heroic measures by the urology service to place a catheter.Patients who had a history of DUC/TUC and those who had greater than one catheter attempts were statistically more likely to be a DUC based on urology assessment.At our institution we hope to propose a protocol in which nursing staff and non-urologic clinicians will utilize a troubleshooting checklist and an algorithm when difficult or traumatic urethral catheters are encountered in order to improve patient care and decrease healthcare costs.For example,this protocol would ideally address complications of multiple catheter attempts such as urethral trauma,development of urethral strictures,and infection risk.Additionally,future trainings and availability of additional resources will be provided and assessed with a goal of reducing healthcare cost surrounding these complications.展开更多
目的:比较Foley尿管低位小水囊与小剂量米索前列醇用于足月妊娠孕妇引产的效果。方法:选取2021年1月—2023年12月于来宾市人民医院分娩的80例足月妊娠孕妇作为研究对象,以随机数表法分为常规组与探究组,各40例。常规组采用小剂量米索前...目的:比较Foley尿管低位小水囊与小剂量米索前列醇用于足月妊娠孕妇引产的效果。方法:选取2021年1月—2023年12月于来宾市人民医院分娩的80例足月妊娠孕妇作为研究对象,以随机数表法分为常规组与探究组,各40例。常规组采用小剂量米索前列醇,探究组采用Foley尿管低位小水囊,比较两组新生儿情况、分娩过程相关指标、宫颈成熟效果、不良母婴结局与母乳喂养情况。结果:两组新生儿出生体重、5 min Apgar评分、干预至临产时间、总产程、母乳喂养率比较,差异无统计学意义(P>0.05);探究组产后出血量少于常规组,宫颈成熟总有效率高于常规组,不良母婴结局发生率低于常规组,差异有统计学意义(P<0.05)。结论:相较于小剂量米索前列醇,Foley尿管低位小水囊在足月妊娠孕妇引产中表现出更好的效果,特别是在减少产后出血、促进宫颈成熟和降低不良母婴结局发生率方面。展开更多
文摘BACKGROUND Urologists are commonly consulted regarding difficult and traumatic urethral catheterizations.Complications surrounding Foley catheterizations represent a significant burden to the healthcare system.AIM To assess the demographic and patient characteristics surrounding urological consultation for difficult and traumatic Foley catheterizations at our institution across multiple hospitals.METHODS This is a single-institution,multi-hospital,263 patient,retrospective chart review from Jan 2020–December 2023.RESULTS The majority of consultations(80.2%)did not require heroic measures by the urology service.A Foley catheter placement was determined not difficult in the majority 191(72.6%)of patients.Sub-group analysis of“difficult by urology”vs“not difficult by urology”,showed a significant difference between those with zero attempts,one attempt,and greater than one attempts(P=0.004).Those patients specifically with greater than one attempts were more likely to be seen as a difficult insertion by urology assessment(60.6%)compared to not difficult(38.6%).Likewise,those patients with a history of difficult urethral catheter(DUC)/traumatic urethral catheterization(TUC)(25.8%)were more likely to be difficult compared to those without a history of DUC/TUC(14.2%)(P=0.038).CONCLUSION The study found that majority of consultations received did not require heroic measures by the urology service to place a catheter.Patients who had a history of DUC/TUC and those who had greater than one catheter attempts were statistically more likely to be a DUC based on urology assessment.At our institution we hope to propose a protocol in which nursing staff and non-urologic clinicians will utilize a troubleshooting checklist and an algorithm when difficult or traumatic urethral catheters are encountered in order to improve patient care and decrease healthcare costs.For example,this protocol would ideally address complications of multiple catheter attempts such as urethral trauma,development of urethral strictures,and infection risk.Additionally,future trainings and availability of additional resources will be provided and assessed with a goal of reducing healthcare cost surrounding these complications.
文摘目的:比较Foley尿管低位小水囊与小剂量米索前列醇用于足月妊娠孕妇引产的效果。方法:选取2021年1月—2023年12月于来宾市人民医院分娩的80例足月妊娠孕妇作为研究对象,以随机数表法分为常规组与探究组,各40例。常规组采用小剂量米索前列醇,探究组采用Foley尿管低位小水囊,比较两组新生儿情况、分娩过程相关指标、宫颈成熟效果、不良母婴结局与母乳喂养情况。结果:两组新生儿出生体重、5 min Apgar评分、干预至临产时间、总产程、母乳喂养率比较,差异无统计学意义(P>0.05);探究组产后出血量少于常规组,宫颈成熟总有效率高于常规组,不良母婴结局发生率低于常规组,差异有统计学意义(P<0.05)。结论:相较于小剂量米索前列醇,Foley尿管低位小水囊在足月妊娠孕妇引产中表现出更好的效果,特别是在减少产后出血、促进宫颈成熟和降低不良母婴结局发生率方面。
