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Development of Indwelling Urinary Catheterization Guideline by Adaptation Process (수용개작방법을 활용한 유치도뇨 간호실무지침 개발)

  • Jeong, Ihn Sook;Jeong, Jae Sim;Seo, Hyun Ju;Lim, Eun Young;Hong, Eun-Young;Park, Kyung Hee;Jung, Young Sun;Choi, Eun Kyoung;Park, Hee Youn;Park, Sun-A
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.1
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    • pp.31-42
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    • 2015
  • Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

Pain Reduction Effects of Lidocaine Gel for Urethral Catheterization : A Systematic Review and Meta-Analysis (요도 카테터 삽입술에서 리도카인 윤활제의 통증 감소 효과 : 체계적 문헌고찰과 메타분석)

  • Hong, Hyun-Jung;Kim, Ga-Eun;Lee, Ha-Nee;Lee, A-Reum
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.438-448
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    • 2017
  • This study was a systematic review and meta-analysis that evaluated the results of research on the pain reduction effects of lidocaine gel for urethral catheterization in adults. A literature search was conducted using seven electronic databases, gray literature and other resources based on the guidelines of Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). A Risk of Bias (RoB) tool was applied to assess the quality of selected studies. Data were analyzed using the RevMan 5.3.-program. Sixteen randomized controlled trials involving 1904 adults were included. RoB was not observed in the funnel plot. Overall, lidocaine gel was effective for pain reduction during urethral catheterization (Standard Mean Difference[SMD] -0.96;95% CI: -1.43, -0.49). To explore the cause of heterogeneity (I2=95%, p<.001), subgroup analysis was conducted according to three catheter types (urinary catheter, flexible cystoscopy, and rigid cystoscopy) and the SMDs were -0.88 (95% CI:-1.51, -0.26), -0.31 (95% CI:-0.63, 0.01), and -1.93 (95% CI:-2.88, -0.97), respectively. A significant pain reduction effect was observed regardless of gender in urinary catheterization. However, in rigid cystoscopy, a significant pain reduction effect was observed only in male subjects. Pain reduction effects were observed when 10~11ml lidocaine gel was used during rigid cystoscopy and when lubrication was used during urinary catheterization, irrespective of application time. These findings suggest that lidocaine gel is a useful anesthetic lubricant for urinary catheterization and rigid cystoscopy in male adults.

Knowledge and Performance Level of Infection Control Guidelines on Indwelling Urinary Catheter, Central Venous Catheter and Ventilator Among Intensive Care Nurses (중환자실 간호사의 유치도뇨관, 중심정맥관 및 인공호흡기 감염관리에 대한 지식과 수행도)

  • Ha, Hyun-Jung;Park, Jung-Ha;Kim, Myung-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.6
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    • pp.113-120
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    • 2016
  • The purpose of this study is to identify the knowledge of and adherence to the infection control guidelines for indwelling urinary catheters, central venous catheters and ventilators among intensive care nurses. The subjects were 175 intensive care nurses working in 2 upper general hospitals and 3 general hospitals. Data were collected from July 1 to July 31, 2013. The collected data were analyzed by descriptive statistics, t-test and ANOVA using SPSS 18.0 for Windows. The mean scores of the knowledge of the infection control guidelines on indwelling urinary catheters, central venous catheters and ventilators were 0.87, 0.82 and 0.82 points, respectively. The average scores for the adherence to the infection control guidelines for indwelling urinary catheters, central venous catheters and ventilators were 4.18, 4.04 and 4.07 points, respectively. Statistically significant correlations were found between the knowledge of and adherence to the infection control guidelines for indwelling urinary catheters (r=.72, p<.00), central venous catheters (r=.54, p<.001) and ventilators (r=.30, p<.001). The knowledge of and adherence to the infection control guidelines for indwelling urinary catheters differed significantly according to gender, educational status, total career, number of patients, type of hospital, and attendance of seminar. The knowledge of and adherence to the infection control guidelines for central venous catheters differed significantly according to educational status, total career, number of patients, type of hospital, and attendance of seminar. The knowledge level of the infection control guidelines for the ventilator differed significantly according to the total career. The results of this study indicate that education and training programs for improving the knowledge of adherence to the infection control guidelines should be developed.

A Comparative study on Perceived Importance and Frequency of Core Nursing Skills between General and Special wards (일반병동과 특수병동의 핵심기본간호술에 대한 중요성인식과 수행 빈도 비교)

  • Chang, Eun-Hee;Mo, Moon-Hee;Choi, Eun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.2
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    • pp.1264-1272
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    • 2015
  • This study was performed to compare the perceived importance and performance frequency of the core nursing skills between general and special department. Subjects were 182 nurses who work on the hospital. Data was collected using items made by Korean accreditation board of nursing education and analyzed by frequency, mean and t-test. There were differences of importance and frequencies about nursing core skill between general and special wards. Core nursing skills of general wards were higher importance on intradermal injection(p=.011), transfusion(p=.028), simple catheterization(p=.047), cleansing enema(p=<.001), preoperative and postoperative care(p=.035), management administration(p=.027) and oxygenation with cannular(p=.002) than special wards. Actual performance frequency core nursing skills of general wards were higher similar on transfusion(p=.002), intermittent tube feeding(p=.032), simple catheterization(p=<.001), cleansing enema(p=<.001), preoperative care(p=.001), postoperative care(p=<.001), management administration(p=.001), protection equipment for quarantine room and waste disposal(p=.021), oxygenation with cannular(p=<.001) than special wards. It is needed to develop efficient and sequential program to learning the nursing core skills for nursing students.

Effects of perineal care in preventing catheter associated urinary tract infections (CAUTI) in intensive care units (ICU) (회음부 간호시 클로르헥시딘과 생리식염수 적용에 따른 유치도뇨관 관련 요로감염 발생률 비교)

  • Choi, Jeong-Sil;Yeon, Jeong-Hwa
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.2
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    • pp.223-232
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    • 2012
  • Purpose: The purpose of this study was to compare the effects of preventing CAUTIs through the practice of using 0.05% chlorhexidine gluconate (CHG) versus normal saline for perineal care in ICU patients. Methods: A randomized controlled trial was used, and participants were randomly allocated to either the CHG group (n=79) or normal saline group (n=81). CAUTI was diagnosed following the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of CAUTI and characte oftics of infection were evaluated. Results: In the CHG group, 8 epofodes of CAUTI were obsevend in 79 patients and 875 foley catheter e ys. Tnce ate of CAUTI was 9.14 per 1,000 foley catheter e ys. Tncre were 2 epofodes of CAUTI in the 81 patients and 837 foley catheter e ys of the normal saline group. Tnce ate of CAUTI was 2.39 per 1,000 foley catheter e ys. Tnc difference between both groups was not significant (p=.1e ConConclusevaluUsing normal saline to provide perineal care to ICU patients with a foley catheter inserted will not increase the risk for CAUTI.

Risk Factors for Nosocomial Urinary Tract Infection in the Intensive Care Unit with a Positive Urine Culture and Foley Catheterization (소변 미생물 균주 양성인 중환자실 유치도뇨관 환자의 병원성 요로감염 발생과 관련요인)

  • Yu, Seong-Mi;Park, Kyung-Yeon
    • Journal of Korean Academy of Nursing
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    • v.37 no.7
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    • pp.1149-1158
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    • 2007
  • Purpose: The purpose of this study was to identify the risk factors for a nosocomial urinary tract infection in intensive care units with a foley catheterization which showed a positive urine culture. Method: Three-hundred eighty-seven patients were included in the study. A retrospective review of the electrical medical record system's databases and medical record sheets in hospitalized patients from January 2003 to December 2003 was used. The collected data was analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. Result: The frequency of the participants' nosocomial urinary tract infection was 72.9%. Significant risk factors for a nosocomial urinary tract infection were 'age', 'place of catheter insertion', 'frequency of catheter change', and 'duration of catheterization'. These variables explained 18.4% of variance in the experience of nosocomial urinary tract infection in intensive care units with foley catheterization. Conclusion: Medical personnel can decrease the incidence of a nosocomial urinary tract infection by recognizing and paying attention to the duration of catheterization, frequency of catheter change, and place of catheter insertion. As a result, specific and scrupulous strategies should be developed to reflect these factors for decreasing nosocomial urinary tract infections.

Knowledge and Practice of the Spinal Cord Injury Patients for the Clean Intermittent Self Catheterzation (재가 척수손상환자의 청결자가도뇨 실태 및 지식 조사 연구)

  • Song, Chung-Sook;Yoo, Hye-Ra
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.1
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    • pp.71-79
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    • 2000
  • The purpose of this study was to examine the knowledge and practice of the Clean Intermittent Self Catheterization (CIC) conducted by Spinal Cord Injury Patients (SPIC) or their significant others as an activity of daily living at their homes or working places. Forty-seven patients were participated in this study. Three questionnaires developed by researchers for this study were used to collect demographic data, knowledge and practice skill of CIC. Descriptive statistics and ANOVA were used to analyze the data. Nineteen (19) patients experienced Urinary Track Infection (UTI) during the last one years and two of them have had several times of UTI. Knowledge level of the participant was not high enough to perform correct CIC. Some evidences indicated that the knowledge did not apply to their practice. Systematic analysis and development of educational content based on this study results was recommended and the systematic instructional design before actual patient education was strongly recommended.

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Effects of Self-evaluation using Smartphone Recording on Nursing Students' Competency in Nursing Skills, Satisfaction, and Learning Motivations: Focusing on Foley Catheterization (자율실습교육에서 스마트폰 동영상을 활용한 자가평가 학습법이 간호술기 수행능력, 자율실습만족도, 학습동기에 미치는 효과: 유치도뇨를 중심으로)

  • Chang, Eunhwa;Park, Soohyun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.2
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    • pp.118-127
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    • 2017
  • Purpose: The purpose of this study was to identify effects of self-evaluation using smartphone recording on competency in nursing skills, satisfaction and learning motivations in nursing students'. The setting was the open laboratory hours. Methods: A quasi-experimental pre/post-test design was conducted in September 2015. The participants were 82 sophomore nursing students from one University. The experimental group did self-evaluation by watching recorded video clips of their performance. The control group did not have any self-evaluation. The primary outcomes were scores from the foley catheterization checklist, scores from a student satisfaction tool, and scores from a learning motivation tool. Data were analyzed using ${\chi}^2$ test, Fisher's exact test, independent t-test, and paired t-test. Results: There was a significant higher mean score in levels of satisfaction by students in the experimental group compared to the control group (t=2.26, p=.027). In addition, improvement in communication skills by the experimental group was significantly higher than improvement in the control group (t=3.96, p<.001). Conclusion: Findings show that self-evaluation using smartphone recordings has positive effects on increasing both communication skills and satisfaction with practice during open laboratory hours. These results indicate that, self-evaluation using smartphone recording is useful as a supplement to traditional open laboratory education.

Urinary Tract Infection Related to The Indwelling Cathete with Closed Drainage (도뇨환자의 유치기간별 요로감염상태에 관한 연구)

  • 이경심;박형숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.3
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    • pp.345-363
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    • 1994
  • This study attempted to identify important problems of the factors related to the indwelling catheter with closed drainage and to enhance recognization of Urinary Tract Infection management to protect patients with indwelling catheter from UTI. We selected the 58 patients with indwelling catheter with closed drainage from md-surg. intensive care units, and general neurological and neurosurgical ward, in one hospital in Pusan, Korea from May 30 to October 15, 1993. Patients were examined by urinary analysis before inserting catheter and then by urine cultures three times. The obtained data was analized using an SPSS /PC$^{+}$ The statistical analyses employed here was the frequency, percentage and x$^2$-tests. 1. Analyses for Indwelling Catheter induced UTI and infection rates were found to be presented in patients related to the factors of being on antibiotic drugs (x$^2$=14.105, p=.000) and the duration of the indwelling catheter(x$^2$=58.0, p=.000), both of which were found to affect the UTI. 2. UTI rates according to the duration of the in-dwelling catheter were high 8.6% for the 2nd day, 27.6 for the 4th day, and 36.2% for the 7th day, and as the duration for the indwelling catheter was longer, UTI rates were higher. 3. The UTI rates according to the duration of the indwelling catheter related re factors, on the 7th day, were high-52.0% for women, 37.0% for more than 50 years in ages, 30.0% for patients under sur-gery, 33.3% for altered mental states outsides the alert, 76.7% for patients not given antibiotic drugs, 36.4% for less than 3500cc of fluids intakes, it was found that these affected to increase the UTI. 4. Causative organisms of UTI were found ; E.Coli appears the most than all other isolated organisms in women and Klebsiella and Pseudomonas in men. For antibiotic susceptibility of causative organisms, all causative organisms were found to be susceptible to Sul -cefoperazone, Trim-prim, and unasyn and Pseudomonas mostly net susceptible.e.

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A Convergence Study on the Effects of Core Nursing Skills Improvement Program on Nursing Skills Competence in Nursing Students (핵심간호술 강화프로그램이 간호학생의 간호술 수행능력에 미치는 효과에 관한 융합연구)

  • Ha, Young-ok;An, Ji-Yoen
    • Journal of the Korea Convergence Society
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    • v.8 no.5
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    • pp.223-231
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    • 2017
  • This convergence study was done to identify the effectiveness of core nursing skills improvement program on nursing skills competence in nursing students. The design of research was one group pretest-posttest and the participants were 158 nursing students. The core nursing skills improvement program was composed of 7 fundamental nursing skills(vital sign, intramuscular injection, oral medication, subcutaneous injection, enema, oxygen therapy and nelaton). The data were collected using self-report questionnaires from January 19 to 23, 2015 and analyzed using paired t-test. The mean score of nursing skills competence in posttest was significantly higher than those in pretest (t=-4.71 ~ -8.00, p<.001). The score for self-confidence(t=-11.61, p<.001) and that for problem solving skills(t=-2.04, p=.043) increased significantly after core nursing skills improvement program. The results indicate that core nursing skills improvement program was effective in improving nursing skills competence.