International Journal of Urological Nursing最新文献

Registered nurses (RNs) competent in catheter insertion and management reduce catheter days and catheter associated urinary tract infections (CAUTIs). Guidelines suggest that education in catheter insertion and management should occur regularly to ensure competency. However, there is no evidence to suggest this occurs in the United Kingdom. The databases Cinahl and Medline databases and the grey literature were searched and revealed that CAUTIs account for ~40% of hospital acquired infections and are associated with increased mortality, morbidity, length of stay and hospital costs. Prevalence, however, can be reduced if all evidence-based measures in insertion and management are carried out. The literature review demonstrated that clinical catheter related education improves nurses' knowledge which, translated into behaviour, results in reduced catheter days and CAUTI rates. A pragmatic, descriptive mixed methods convergent parallel approach was used to survey RNs from two professional associations through their mailing lists and social media platforms, using an online Qualtrics™ questionnaire. An online survey method was chosen to maximize geographical reach. Respondents confirmed their consent on accessing the online survey prior to commencing the questionnaire. All participants and their responses were anonymous. Results were saved on the Qualtrics™ platform and analysed quantitatively using descriptive statistics and qualitatively using a pragmatic approach to thematic analysis. Of the 72 responses, 61% (n = 44) worked in an acute hospital and 47% (n = 34) worked in the London area. There was representation from all over the United Kingdom except Scotland. 96% (n = 69) RNs were offered education in catheter insertion and management. Content of education included theory, practical, competency and ongoing education. 51% (n = 36) were offered education on a frequent basis. The results indicated that education in catheter insertion and management for RNs in the United Kingdom is not standardized. This may have implications for patient outcome measures such as CAUTI and on a macro level may be a symptom of wider organizational cultural inadequacies. Future research could inform the design of a standardized catheter insertion and management education package and measure its effect and impact on practice. The sampling method and subsequent response rate was a limitation of this study, and it may have been appropriate to use a more generic sampling frame to achieve representative results.

Prostate cancer has become the 2nd most common cancer in men worldwide. An ageing population and treatment improvements are increasing the number of men living with and beyond cancer. In 2013, there was both scant evidence to guide as to when, where or how men with prostate cancer should be followed up and neither, it appears, pointing to agreed pathways. Generally, follow up regimes are based on tradition and expert medical opinion rather than research or patient need. For men to have their follow up with their GP, several factors need to be in place such as a single system, an improved exchange of experiences, as well as information and knowledge sharing. A recent presentation of a randomized control trial has shown that there are no differences between secondary and primary care follow up. Understanding that the current model of follow up was not working and was unsustainable, a review of urological services was undertaken in 2011 in a large National Health Service (NHS) district general hospital in the north of England. The review evaluated current services, noting that some follow up pathways did not necessarily need to be undertaken within a secondary are setting. The process of relocating patients for primary care review, involved creating a shared care process for prostate cancer. A workstream consisting of consultant urologists, nurse specialists, GPs, service managers and clinical commissioners was convened. Protocols containing specific responsibilities for secondary and primary care were devised. The review and workstream, included a shared vision for improving and sustaining services. Whilst safely moving follow up from secondary to primary care, benefits were realized such as care closer to the home. In conclusion a radical approach to follow up was needed and undertaken. Shared care has yielded success for the patient, primary and secondary care.

This study aimed to gain insight into how older men diagnosed with prostate cancer experience responding to ePRO about their quality of life in a clinical trial as well as what motivates and demotivates them in the process. Drop-outs in patient-reported outcome studies are a well-known challenge that influence both the reliability and validity of clinical trials. Furthermore, retaining older people in electronic patient-reported outcome (ePRO) studies has proven difficult. This study was based on qualitative semi-structured interviews with 13 male patients. The interviews were conducted between April and May 2022 and were audio-recorded and transcribed verbatim. We analysed the interview inductively using Braun and Clark's thematic analysis. Resulting in five core themes among participants' responses: (1) the ePRO frame is feasible, (2) it is challenging to rate one's life on a scale, (3) increased disease insight, (4) unmet expectations of emotional support, and (5) from motivation to demotivation. The informants were motivated primarily by the idea of helping with new knowledge, but also because ePRO was seen as easy to use and access from home. They were further motivated by the new knowledge they gained through ePRO about symptoms and the possibility to follow their own progress. However, relating to their own quality of life creates an expectation that nurses and doctors will do the same in their treatment, and when this does not happen, the initial motivation turns into demotivation as ePRO knowledge was not used to tailor their treatment and follow-up. In conclusion, older men can participate in ePRO. They are motivated by helping with new knowledge, the ability to answer ePRO from home, and the insights they gain from the questionnaire. They lose motivation when their responses are not used to tailor their disease management.