Knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter

Objectives:The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.Materials and Methods:This cross-sectional study was conducted from June 1,2021,to September 11,2021,in a tertiary hospital in north India.Purposive sampling was used to select 50 participants.Three instruments were employed for data collection after fulfilling sample criteria;for baseline information demographic tool,knowledge questionnaires,and a practice checklist.Data were analyzed using descriptive and inferential statistics.Results:On assessment of 50 participants,the majority of parents aged above 30 years(74%).Most of the participants were male(82%),graduated(38%),and working in the private sector(58%).Similarly,two-thirds of participants were residing in a nuclear family(64%)with a single child 32(64%)and family income<5000 rupees per month(60%).The mean score of knowledge was 1.94±0.81 and that of practice skills was 1.98±0.85 on home-based care.Regression analysis showed that knowledge of parents was significantly associated with qualification(β:1.821,P=0.002).Similarly,association of practice skills of parents with gender(β:1.235,P=0.050)and qualification(β:1.889,P=0.00)was significant.Conclusion:The general findings of our study showed that parents’education and occupation played a significant role in a child’s care.Parental education and catheter care skills positively affect the child and reduce readmission rates.

Epidemiological Study of Rapidly Emerging Uropathogens Isolated from Urinary Catheter and Its Influential Demographic Factors Responsible for Contamination

Urinary tract infections (UTI) are very common in all the developed as well as developing countries in which the majority of infections are catheter associated. Catheter associated urinary tract infections (CAUTI) is one of the major causes of hospital acquired infections. The aim of this study is to investigate influential demographic factors responsible for contamination associated with the rate of CAUTI, while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis, age, gender, and comparison with other studies. During the study, 22 uropathogenic species were isolated from the different segments of urinary catheter samples of the patients collected from 12 different hospitals of Amravati city, Maharashtra, India from January 2015 to 2018. Gram negative organisms were the most frequent isolates, with Pseudomonas aeruginosa (16.08%) being the most common followed by Escherichia coli (10%) and Candida albicans accounted for almost 11% of all the uropathogens. It was found that the majority of uropathogens were isolated from the section A (Catheter segment inside the bladder) and section E (Catheter segment connected to drainage tube) of the urinary catheter. The duration of the catheterization plays the major role in the contamination and further infection to continue. It was observed that the female catheterized patients are more prone to the contamination and infection as compared to male catheterized patient. The antibiotic sensitivity pattern indicates that MAR (Multiple Antibiotic Resistance) index was more than 0.2 for almost all the uropathogens tested concluding that there is antibiotic stress on uropathogens and rate of resistance increased rapidly. Also it was found that there was a statistically significant association between the duration of catheterization, type of disease, age of patient and type of catheter with respect to gender.

Effect of Cluster Nursing in Preventing Urinary Tract Infection in Postoperative Patients with Indwelling Urinary Catheter

Objective:This paper expounds and analyzes the effect of cluster nursing in preventing urinary tract infection in postoperative patients with indwelling urinary catheter.Methods:A total of 400 postoperative patients with indwelling urinary catheter,treated in Yancheng No.1 People’s Hospital in recent two years,were recruited as research subjects.The patients were equally divided into group A and group B,with 200 patients in each group,and all received routine anti-infectives.The patients in group A(200 cases)received routine nursing.On the basis of group A,cluster nursing was implemented for patients in group B(200 cases).Results:The indwelling time of urinary catheter,the disappearance time of bladder irritation symptoms,and the probability of urinary tract infection were compared between both groups,which showed that the nursing effect of group B was better than that of group A(P<0.05).Conclusion:The implementation of cluster nursing in postoperative patients with indwelling urinary catheter can improve the deficiency of routine nursing,consolidate the treatment effect,and reduce the complication rate of urinary tract infection.

Urinary catheterization management after vaginal prolapse surgery:A national survey among Chinese urogynecologists and nurses

Background:Urinary catheterization after vaginal prolapse surgery can cause inconvenience for patients,elevate the risk of urinary tract infections,and potentially prolong the hospitalization.In China,there is no consensus on the optimal time to remove the urinary catheter after vaginal prolapse surgery.Thus,it will be valuable to gain insight into the nationwide catheterization management after the vaginal prolapse surgery.Methods:From March to May 2020,an online questionnaire was shared and purposive non-probabilistic sampling was used to recruit the participants.The urogynecologists currently performing vaginal prolapse surgery and involved nurses were included in this study.Results:1363 urogynecologists and 436 nurses responded and 99.5%of them reported using transurethral indwelling catheters(TIC)for post-operative bladder drainage in their practices.The duration of initial catheterization after vaginal prolapse surgery was generally 1–7 days,with a median duration of 3 days for anterior colporrhaphy(AC)and anterior&posterior colporrhaphy(APC),and 2 days for other procedures.For the same type of surgery,the median duration of catheterization varied by region.For AC,it was shorter by 1 day in West China and South China(P<0.001);for PC,it was 2 days in most regions,while 1 day in East China(P<0.05);and for APC,it was 3 days in most regions,while 4 days in Northeast China(P<0.05).No statistically significant difference was found in duration of catheterization in hospital levels.Conclusions:The findings suggested that duration of catheterization after prolapse surgery varied greatly in China,potentially resulting in unnecessary prolonging of catheterization.Well-designed studies are urgently needed to optimize catheterization management after vaginal prolapse surgery in China.

Underpad weight to estimate urine output in adult patients with urinary incontinence

To the Editor Monitoring urine output remains essential to the care of adult patients admitted to the hospital. In acute, decompen- sated heart failure, ongoing assessment of urine output is required to adjust diuretic dosing in keeping with current recommendations for hospitalized patients, In patients with acute kidney injury, assessment of urine output is essential for diagnosis and management. The diagnosis of circulatory shock is supported by renal hypoperfusion as measured by low urine output. Indwelling urinary cathe- ters are routinely used for the ＂strict＂ monitoring of urine output, which is an accepted indication.

Purple urine bag syndrome:An unusual manifestation of urinary tract infection,our experience at a tertiary care center

Background:Purple urine bag syndrome(PUBS)is an unusualconditionin which a purple discoloration of urine and bag occurs in people with urinary catheters.People with purple urine usually do not complain of any symptoms.The purple discoloration of the urine bag is often the only finding,frequently noted by caregivers.Materials and methods:This prospective observational study was conducted at our tertiary care institute from June 2018 to May 2020.A total of 46 patients with PUBS wereincluded in this study.The objective of our study was to record the prevalence of each predisposing factor and to correlate the pathological mechanism through which the PUBS is manifested.Results:The mean age of PUBS patients was 67.4years and 67.4%were males.Most patients of PUBS(60.9%)had a urethral catheter,while there was percutaneous nephrostomy in 26.1%patients and 13%patients had a percutaneous suprapubic cystostomy catheter.Among the patients,69.65%were bedridden orin an institutionalized situation,73.9%were suffering from chronic constipation,21.7%were associated with dementia,and 47.8%were cerebrovascular accidents with hemiparesis patients.In addition,93.5%of patients presented with alkaline urine and 3 patients with acidic urine.The most common bacteria isolated in urine culture were E coli and Pseudomonas.Conclusions:Urinary catheter associated urinary tract infection and PUBS is most commonly documented in females,but our study showed that it is more common in males.The appearance of a purple bag does not depend on the material and type of the catheter or the catheterization method.In addition,no correlation was found between the microorganisms isolated from the environment and patients'urine.

Avoidance of urinary drainage during perioperative period of open elective colonic resection within enhanced recovery after surgery programme

Background:Urinary catheterization(UC)is a conventional perioperative measure for major abdominal operation.Optimization of perioperative catheter management is an essential component of the enhanced recovery after surgery(ERAS)programme.We aimed to investigate the risk factors of urinary retention(UR)after open colonic resection within the ERAS protocol and to assess the feasibility of avoiding urinary drainage during the perioperative period.Methods:A total of 110 colonic-cancer patients undergoing open elective colonic resection between July 2014 and May 2018 were enrolled in this study.All patients were treated within our ERAS protocol during the perioperative period.Data on patients’demographics,clinicopathologic characteristics,and perioperative outcomes were collected and analysed retrospectively.Results:Sixty-eight patients(61.8%)underwent surgery without any perioperative UC.Thirty patients(27.3%)received indwelling UC during the surgical procedure.Twelve(10.9%)cases developed UR after surgery necessitating UC.Although patients with intraoperative UC had a lower incidence of post-operative UR[0%(0/30)vs 15%(12/80),P=0.034],intraoperative UC was not testified as an independent protective factor inmultivariate logistic analysis.The history of prostatic diseases and the body mass index were strongly associated with post-operative UR.Six patients were diagnosed with post-operative urinary-tract infection,among whom two had intraoperative UC and four were complicated with post-operative UR requiring UC.Conclusion:Avoidance of urinary drainage for open elective colonic resection is feasible with the implementation of the ERAS programme as the required precondition.Obesity and a history of prostatic diseases are significant predictors of postoperative UR.