The role of the district nurse in managing blocked urinary catheters

This article will investigate the district nurse's role in managing urinary catheter blockages, looking at why people require long-term catheterisation and the causes of blockages and then reviewing treatment methods. Current practice will be critically analysed and compared to the most up to date research and literature to inform district nurses of best evidence-based practice in the hopes of improving service user outcomes and quality of life and reducing the impact this problem has upon district nursing services with regards to time and resources.

Development of a Computer Application Used by Visiting Nurses, Physicians, and Patients/Caregivers to Prevent Indwelling Urinary Catheter Occlusion in the Community

This study aimed to develop a computer application (software) for use by visiting nurses, physicians, and patients/caregivers, to support their care of long-term indwelling urinary catheters in the community. Development of this application involved: (1) confirmation of the intended purpose, users, and application construction; (2) establishment of the functional requirements for data sharing and communication among visiting nurses, physicians, and patients/caregivers; (3) design of three constituent "versions" of the application to be used by visiting nurses, physicians, and patients/caregivers, respectively; and (4) testing of the data sharing and communication functions. The application was designed to facilitate the prevention, assessment, and response to occlusion of indwelling urinary catheters during long-term use at home. This application is characterized by: (1) a unique design of three application "versions" that each reflect the specific care roles of its respective user group; (2) data sharing among the three groups according to their respective roles; and (3) the inclusion of caregivers as users. This article proposes a model that can inform the design of future applications for nursing professionals and patients and caregivers and provide a basis for future research on the development of healthcare applications supporting improvements in care.

Prevalence and indications of long-term indwelling urinary catheter among out-patients attending urology clinic at a tertiary hospital in Northwestern Tanzania

Background

People living with long-term indwelling urinary catheterization at home are increasing globally. Few studies on prevalence have been done globally and none in Sub-Saharan Africa. This study investigated the prevalence and indications of long-term indwelling urinary catheterization (IUC) at home in Northwestern Tanzania and to determine the reasons for staying long with an indwelling urinary catheter after diagnosis of benign prostatic hypertrophy was confirmed.

Methods

This was a cross-sectional study conducted at urology clinic at Bugando Medical Centre, a referral hospital in the Northwestern Zone of Tanzania. The study population included 2112 patients attending the urology clinic from December 2016 to September 2017 with different conditions. From this population, 202 out-patients living with a long-term IUC either suprapubic or urethral were conveniently selected. A review of hospital records of these 202 out-patients was done using a pre-tested checklist. Patients were interviewed to collect additional information. Data were analyzed using STATA version 13(college station, Texas). Descriptive statistics were used for categorical variable, whereas median [inter quartile range (IQR)] was used for continuous variables.

Results

The prevalence of out-patients living at home with an IUC was 9.6% (202/2112), CI (8.4–10.8). Age ranged from 18 to 95 years with the median age of 69 [IQR 61–77] years. Males 195(96.5%) formed the majority of participants. A total of 111 (54.9%) had catheters for ≥ six weeks and 123 (60.9%) had their catheters changed at least once. Common indications were benign prostatic hypertrophy (BPH), 129 (63.9%) and urethral stricture 34 (16.8%). Reasons for the long stay with an IUC at home, especially for those without National Health Insurance Fund (NHIF) 49(94.2%) were endless appointments 23(52.3%), no money to pay for surgery 9(20.5%) and medical conditions 7 (16%). Only 3(0.1%) were under NHIF and were treated promptly.

Conclusion

Prevalence of long-term IUC in Northwestern Tanzania is high. Improved health care system is required to lower the high prevalence of long-term IUC at home through training of more urologists and these patients to be under the scheme of NHIF.

Issues Related to the use of a Mobile Application of the Protocol for Preventing and Managing Urinary Catheter Blockage Among Long-term Indwelling Urinary Catheter Users for Visiting Nurses: An Interview Study of Visiting Nurses in Japan

Background:

We developed a mobile application of the protocol for preventing and managing catheter blockage among long-term indwelling catheter users for visiting nurses. We conducted meetings at four visiting nurse stations in Japan from May to June 2017 to explain the application to visiting nurses.

Objective:

The purpose of the present study was to clarify issues related to the full-scale use of this protocol application, using data from focus group interviews with visiting nurses.

Methods:

We conducted focus group interviews with the meeting participants. The focus group interviews were conducted at four different venues. Three focus groups had eight participants, and the fourth had two participants, for a total of 26 study participants. Specifically, the group interviews covered (1) the application’s structure and content; (2) operability; (3) portability; (4) possibilities for use, effects, and expectations; and (5) concerns about use.

Results:

The results of the group interviews were classified into five categories: possibilities for the use of the mobile application, possibilities for further use of the application by nurses, suggestions for the use of the application by caregivers and nursing care workers, the burden associated with the use of the mobile application, and opinions and desires for improvements in the mobile application.

Conclusion:

The results suggested that visiting nurses would use the mobile application. However, for full-scale use, it would be necessary to add the ability to use accumulated data, increase the number of learning screens, and take safety management measures for the transmission of medical information.

Prevention and management of urinary catheter blockages in community settings

Self-management of long-term urinary catheters can be challenging for patients, and recurrent catheter blockages may cause concern among patients, carers and healthcare professionals. Catheter blockages are a significant challenge for nurses practising in community settings, because frequent and unplanned catheter changes can be costly to healthcare services in terms of time and resources. This article details evidence-based recommendations for the assessment and diagnosis of catheter blockages, as well as the identification of risk factors. It also explains the interventions that can be used to prevent and manage catheter blockages and describes the role of the nurse in supporting patients with a long-term catheter in situ in community settings.