Evaluation of a new model of care for bladder management in a statewide spinal cord service.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY Spinal cord Pub Date : 2025-01-15 DOI:10.1038/s41393-024-01059-5

Belinda J Gabbe, Stacey Rj Haughton, Andrew Nunn, Marnie Graco, Chris Michael, Sandra Reeder, Rebekah McGaw, David J Berlowitz

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Abstract

Study design: Registry-based cohort study.

Objectives: To evaluate the impact of the introduction of a new bladder management model of care at the Victorian Spinal Cord Service (VSCS) on the incidence of subsequent emergency department presentations and readmissions to hospital for urinary tract infection (UTI) in the first 2 years after injury.

Setting: VSCS, Austin Health, Melbourne, Australia.

Methods: A new model of care that prioritized intermittent self-catheterization was implemented at the VSCS on 1 August 2017. Data from the Victorian State Trauma Registry and Austin Health medical record were used to compare the rate of readmissions, emergency department (ED) presentations and hospitalisations for UTI in the first two years post-injury before and after practice was changed.

Results: A total of 333 cases were included; 149 cases pre-model of care change and 184 cases after. 143 males and 41 females with a mean (SD) age of 48.9 (19.7) were admitted to the VSCS following the change in model of care. The rate of any subsequent hospitalisation for UTI (ED presentation or admission) was lower following the introduction of the new bladder management model of care (Incidence rate ratio 0.30, 95% CI 0.12-0.73).

Conclusions: Our data demonstrates the real-world impact of a change in bladder management after new SCI. These data strengthen the consensus recommendation in current practice guidelines.

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评估一种新的护理模式膀胱管理在全国脊髓服务。

研究设计：基于登记的队列研究。目的：评估维多利亚脊髓科（VSCS）引入新的膀胱管理模式对损伤后头2年内因尿路感染（UTI）出现急诊和再入院的发生率的影响。单位：澳大利亚墨尔本奥斯汀健康中心VSCS。方法：2017年8月1日在VSCS实施了优先考虑间歇性自我导尿的新护理模式。来自维多利亚州创伤登记处和奥斯汀健康医疗记录的数据用于比较受伤前后两年内尿路感染的再入院率、急诊科（ED）报告率和住院率。结果：共纳入病例333例；护理模式改变前149例，改变后184例。143名男性和41名女性，平均（SD）年龄为48.9岁（19.7岁），在改变护理模式后进入VSCS。引入新的膀胱管理模式后，任何后续尿路感染住院率（ED表现或入院）都较低（发病率比0.30,95% CI 0.12-0.73）。结论：我们的数据证明了新的脊髓损伤后膀胱管理的改变对现实世界的影响。这些数据加强了当前实践指南中的共识建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spinal cord 医学-临床神经学

CiteScore

4.50

自引率

9.10%

发文量

142

审稿时长

2 months

期刊介绍： Spinal Cord is a specialised, international journal that has been publishing spinal cord related manuscripts since 1963. It appears monthly, online and in print, and accepts contributions on spinal cord anatomy, physiology, management of injury and disease, and the quality of life and life circumstances of people with a spinal cord injury. Spinal Cord is multi-disciplinary and publishes contributions across the entire spectrum of research ranging from basic science to applied clinical research. It focuses on high quality original research, systematic reviews and narrative reviews. Spinal Cord''s sister journal Spinal Cord Series and Cases: Clinical Management in Spinal Cord Disorders publishes high quality case reports, small case series, pilot and retrospective studies perspectives, Pulse survey articles, Point-couterpoint articles, correspondences and book reviews. It specialises in material that addresses all aspects of life for persons with spinal cord injuries or disorders. For more information, please see the aims and scope of Spinal Cord Series and Cases.