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.

The aim of this study was to analyse the experience of users of indwelling bladder catheters and evaluate the anticipated usability of a prototype of the T-Control® urinary catheter (without being inserted) by patients who were able to compare the differences between the T-Control® prototype and other urinary catheters and urinary catheter accessories. A qualitative study was conducted with people who had lived with an indwelling urinary catheter for at least 1 week. Two user-centred design techniques were applied: patient experience trajectory map and Think Aloud, a method where the participants were able to express their previous experiences, expectations and preferences while manipulating the devices. The experiential trajectory was collected based on a semi-structured following interviews. Participants were able to manipulate the new T-Control® and, based on their previous experiences, compare the potential usability of T-control® with Foley-type catheter and its accessories All the participants stated that they had experienced negative emotions concerning bladder catheterisation during the trajectory of use, from the initial prescription and adaptation to the follow-up, and the forced life changes that a permanent catheterisation implies. The most frequent emotions were rejection and sadness. The new T-Control® device could potentially improve the patient experience, as all participants perceived advantages related to the closure system, ease of use, safety and discretion. Participants also noted its closure system as an advantage and highlighted its ease of use, although one-handed operation required some learning. Catheters currently on the market are functional, but some patients do not always have a satisfactory experience. This might negatively affect their quality of life, so there is a wide market opportunity for new devices that improve clinical and psychological care. Based on patient evaluation, the new T-Control® device with a built-in valve could provide benefits for patients.

This article aims to present updates and review current practise on the main imaging modalities used in diagnosis of bladder and prostate cancer and provide this to readers. Patients diagnosed with or having treatment for a urological cancer are a huge part of any urological nurses' rota or clinical responsibilities, particularly now in an era of ever changing and improving diagnosis and management options. In this manuscript a practical overview of imaging is given to influence a fuller understanding of therapeutic management in prostate and bladder malignancies. For the purpose of this article there is only a focus on imaging in terms of diagnosis and staging purposes. It is hoped that detailed use of imaging in radiotherapy and brachytherapy for planning and treatment verification will be the subject of a separate paper but, for now, it is briefly mentioned for readers that may be less familiar with radiation oncology. Discussion and overview of imaging modalities used in the diagnosis of prostate and bladder cancer will improve understanding for urology nurses, especially junior career nurses.

Catheter associated urinary tract infection (CAUTI) is the most prevalent healthcare-associated infection worldwide, and the use of care bundles such as CAUTI bundles has been identified as the most effective ways of preventing it. This cross sectional descriptive study thus, evaluated the application and barriers to application of CAUTI bundles in patients' care among nurses in a tertiary government hospitals. Census method was used to recruit into the study all 446 registered nurses and midwives who met the inclusion criteria in the institution; thus, no sampling was done to select the participants from the study area. Data were collected by means of researchers' developed and validated semi-structured self-administered questionnaire delivered through Google drive. Univariate and bivariate data analyses were conducted with the aid of SPSS version 24. Results of the study revealed that only 7 (1.9%) of the nurses claimed they always use written guidelines during catheter insertion, whilst majority 57.4% do not follow any written protocol or guidelines when inserting catheter. The use of aseptic non-touch technique was always done by 80% of the respondents. In general, score on compliance with the bundles was poor, as only 46.4% of the respondents correctly apply the bundles to patients' care. Barriers to application of the bundles as revealed by the results include; lack of written policy/guideline documents on CAUTI bundles in the facility (100%), lack of existing monitoring and feedback tools (98.9%), Supervisors/staff do not feel empowered to challenge suboptimal practices in a safe way (52.4%), lack of team meeting/ward round routinely addressing patients with indwelling urinary catheter (78.6%). It is thus, imperative to conclude that although the nurses in this study have some knowledge about the catheter associated urinary tract infections' bundles, their application of the bundles to patients' care is very poor, and was found to be due to some modifiable barriers. These barriers are some of the areas nurse educators and hospital policy-makers should focus in their bid to curbing healthcare acquired infections.

We sought to evaluate the effectiveness and acceptability by patients of transcutaneous sacral roots neuromodulation (TSRN) by paravertebral placement of surface electrodes to treat pelvic pain and pelvic muscle stiffness. Pelvic pain is a disabling condition, often related to non-relaxing pelvic muscles. Causes for the onset are often unclear; noninvasive treatment targeted at maintenance factors can be administered by nurses in some countries. previous studies have investigated the role of invasive stimulation for pelvic pain; TSRN has proved successful in other pelvic disorders. We conducted a pilot study on a sample of consecutive patients of both genders, reporting pelvic pain (chronic or not). Weekly sessions of TSRN with surface electrodes were performed; pain was recorded with the numeric rating scale (NRS) at baseline and after the end of the rehabilitation plan. Therapeutic success was defined as a reduction of 50% in pain scores. Twenty patients were enrolled, most complaining multiple symptoms apart from pain. Seven males had primary prostate pain syndrome, one had history of orthopaedic surgery, and eight had muscle stiffness (Median = 3 out of 4, IQR = [3;3], range [2;4]). Sixteen patients (12 males and 4 females) had chronic pelvic pain. The median NRS values in the sample at baseline was 4[5.5–7.5] with no significant differences between genders (p = 0.144) and decreased significantly (Me = 0.5, IQR[0.0–1.0], p < 0.001) after a median of 20 weekly sessions (range [10–30]). The results indicated clinically relevant benefit for all patients (ω² = 0.689, 95%IC[0.505–0.793]) Decrease in pelvic muscle stiffness was significant (from Me = 3, IQR [3] to Me = 0, IQR[0–1], p < 0.0001) without differences between the genders (p = 0.711). No significant difference was found in the number of sessions required by males and females to achieve therapeutic success (p = 0.282). TSRN seems a promising treatment for pelvic pain and can be performed in outpatients' clinics with low costs and no invasivity. Further studies on larger, randomized samples are required to confirm these results.