A Nurse-Led Voiding Algorithm for Managing Urinary Retention After General Thoracic Surgery.
Background: Untreated postoperative urinary retention (POUR) leads to bladder overdistension. Treatment of POUR involves urinary catheterization, which predisposes patients to catheter-associated urinary tract infections. The hospital's rate of POUR after lobectomy was 21%, exceeding the Society of...
| Published in: | Critical Care Nurse Vol. 42; no. 1; pp. 23 - 32 |
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| Main Authors: | , , , , |
| Format: | research tables/charts Journal Article |
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American Association of Critical-Care Nurses
Feb2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=154976914&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 154976914 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02795442 1GD jtl: Critical Care Nurse issn: 02795442 maglogo: N pubinfo: dt: Feb2022 vid: 42 iid: 1 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 154976914 154976914 154976914 10.4037/ccn2022727 154976914 ppf: 23 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: A Nurse-Led Voiding Algorithm for Managing Urinary Retention After General Thoracic Surgery. aug: au: Pierson, Mary Cretella, Brittany Roussel, Maureen Byrne, Patricia Parkosewich, Janet affil: Mary Pierson is the assistant nurse manager of the medical intensive care stepdown unit, Yale New Haven Hospital. At the time this article was written, she was the assistant nurse manager of the 5-4 thoracic stepdown unit, Heart and Vascular Center, Yale New Haven Hospital, New Haven, Connecticut sug: subj: Thoracic Surgery Methods Urinary Retention Prevention and Control Urination Nursing Care Algorithms Hospital Programs Human Surgical Patients Urinary Catheterization Postoperative Care Magnet Hospitals Documentation Bladder Radiography Descriptive Statistics T-Tests Chi Square Test Cross Sectional Studies Descriptive Research Academic Medical Centers Connecticut Multidisciplinary Care Team Expert Clinicians Program Implementation Staff Nurses Education Data Analysis Software Male Female Middle Age Age Factors Sex Factors Comorbidity Anesthesia Middle Aged: 45-64 years Male Female ab: Background: Untreated postoperative urinary retention (POUR) leads to bladder overdistension. Treatment of POUR involves urinary catheterization, which predisposes patients to catheter-associated urinary tract infections. The hospital's rate of POUR after lobectomy was 21%, exceeding the Society of Thoracic Surgeons' benchmark of 6.4%. Nurses observed that more patients were being catheterized after implementation of a newly revised urinary catheter protocol. Objective: To reduce the incidence of POUR by implementing a thoracic surgery–specific nurse-led voiding algorithm. Methods: Experts validated the voiding algorithm that standardized postoperative assessment. It was initiated after general thoracic surgery among 179 patients in a thoracic surgery stepdown unit of a large Magnet hospital. After obtaining verbal consent from patients, nurses collected demographic and clinical data and followed the algorithm, documenting voided amounts and bladder scan results. Descriptive statistics characterized the sample and the incidence of POUR. Associations were determined between demographic and clinical factors and POUR status by using the t test and χ2 test. Results: The POUR-positive group and the POUR-negative group were equivalent with regard to demographic and clinical factors, except more patients in the POUR–positive cohort had had a lobectomy (P =.05). The rate of POUR was 8%. Society of Thoracic Surgeons reports revealed a rapid and sustained reduction in the hospital's rates of POUR after lobectomy: from 21% to 3%. Conclusion: The use of this nurse-led voiding algorithm effectively reduced and sustained rates of POUR. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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