This article presents findings of a quality improvement (QI) project using the DMAIC (define, measure, analyze, improve, and control) model designed to decrease the rate of emergency department (ED) visits and nurse advice line calls after ureteroscopic stone surgery. Results indicated that nurse-initiated follow- up phone calls can decrease ED visits.
This health economic evaluation simulated a cohort to compare hydrophilic-coated to non-coated catheters for intermittent catheterization. By using a Markov model, lifetime costs and catheter-related complications were investigated. Results determined that the use of hydrophilic-coated catheters save money and reduce treatment-related complications.
Urinary incontinence (UI), typically a sensitive and personal concern, has been amendable to healthcare interventions via telehealth applications. Telehealth has been identified as a method capable of providing care to rural locations based on its ability to eliminate the need for patient and/or healthcare provider travel. The purpose of this project was to determine if telehealth improved follow-up visit rates among rural dwelling patients with UI. Additional data were collected to assess the effect of treatment recommendations, patient perception of this experience, and healthcare team opinion of telehealth implementation. Results reflect an improvement in follow-up rates, effectiveness of the treatment plan, patient satisfaction, and healthcare team support.
In the United Kingdom, our Health Needs Assessment survey return rate of 42% identified unmet needs in subjects with prostate cancer. Subjects reported the greatest unmet need was related to erectile dysfunction. Other unmet needs were related to incontinence, tiredness, hot flashes, lower urinary tract symptoms, rectal bleeding, and relationship issues.
Catheter-associated urinary tract infections (CAUTIs) are one of the most common hospital-acquired infections in the United States. Because of persistently high CAUTI rates despite evidence-based interventions, we designed and implemented a performance improvement nurse-driven removal protocol for indwelling urinary catheters. Post-implementation, both catheter utilization and CAUTIs decreased significantly at the one hospital with the highest baseline rates; at the two hospitals with low baseline rates, the impact of the protocol varied. This project highlights important steps in developing and implementing a nurse-driven removal protocol across a multi-hospital academic healthcare system.
This article describes the analysis of the concept of health seeking in men. Men have shorter life expectancies and utilize health services less often than women, leading to poor health outcomes, but a gendered basis for health seeking remains poorly defined. Walker and Avant’s framework was used to guide this concept analysis. Literature published in English from 1990-2015 was reviewed. Thematic analysis identified attributes, antecedents, and consequences of the concept. Based on the analysis, a contemporary definition for health seeking in men was constructed, rooted in the concept of health. The definition is based on the concept analysis and the defining attributes that were identified. This analysis provides a definition specifically for health seeking in American men, making it more specific and gender-based than the parent concept of “health.” This concept analysis provides conceptual clarity that can guide development of a conceptual framework that may be uniquely relevant to providers in urology. Further exploration will uncover specific cultural, social, sexual, and geographic perspectives.
The Braden scale is a widely used tool to assess pressure ulcer risk. Preoperative Braden scores were significantly associated with postoperative morbidity among women undergoing urogynecologic surgery for stress incontinence and pelvic organ prolapse.
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