• 재활간호학회지
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• 제2권1호
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• pp.72-84
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• 1999

The purpose of this study was to identify the effectiveness of bladder training on self voiding after removal of catheter in female patients with craniotomy, finally to develop a bladder rehabilitation program for cognitive impaired patients. Nonequivalent control group posttest design was used. The population of this study consisted of 34 hospitalized neurosurgical patients, all patients have been received craniotomy. 17 patients were assigned to the experimental group and another 17 patients to the control group. The homogeneity of general characteristics of the subjects was no significant difference. Bladder training program consisted of pre-training education, the bladder training, positive verbal reinforcement. The experimental group has been received bladder training and the control group has been received gravity drainage. The dependent variable, the frequency of voiding trial untill self voiding achieves, the frequency of urinary retention, the amount of residual urine, the occurrence, of urinary incontinence, were measured during 3 days after catheter removed. The data analyzed with SPSSWIN ; frequency, percentage, t-test and $X^2$-test were used to analyze homogeneity of general characteristics of subjects between the experimental and the control group. T-test, Mann-Whitney U test, and $X^2$-test were used to determine the effect of bladder training. The result of the study were as follows : There was significant difference in the frequency of voiding trial untill self voiding achieves between the experimental group and the control group. There was no significant difference in the frequency of urinary retention between the experimental group and the control group. There was no significant difference in the amount of residual urine between the experimental group and the control group. However, there was significant difference in the amount of residual urine in urinary retention patients. There was significant difference in the occurrence of urinary incontinence between the experimental group and the control group. In conclusion, bladder training program as a nursing intervention was effective in conclusion, bladder self voiding ability after removal of catheter for craniotomy patients. Therefore, it is recommended to use the bladder training program clinically for the bladder management of cognitive impaired patients.

• 임상간호연구
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• 제25권3호
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• pp.303-313
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• 2019

Purpose: The purpose of this study was to examine nurses' knowledge, health beliefs, and performance regarding the infection control of catheter-associated urinary tract infection (CAUTI) and to identify factors affecting their infection control performance of the CAUTI. Methods: The subjects were 166 nurses at three hospitals with less than 300 beds in urban areas.Data were collected using structured questionnaires about knowledge, health beliefs, and performance regarding the infection control of the CAUTI. Statistical analysis included t-test, ANOVA, Pearson's Correlation Coefficients, Multiple regression analysis. Results: The factors affecting the infection control performance of CAUTI were knowledge (β=.18, p=.010), perceived seriousness (β=.25, p=.001), perceived barriers (β=.41, p<.001), and cues to action (β=.15, p=.030), and these factors explained 28.7% of the variance for the infection control performance of the CAUTI. Conclusion: In this study, higher levels of knowledge, perceived seriousness and, cues to action, and lower perceived barriers resulted in a corresponding higher performance in the infection control of CAUTI. Based on these findings, providing intervention programs enhancing the health beliefs of nurses is necessary to ensure their infection control performance of the CAUTI.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.99-103
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• 2010

Purpose: Blow-out fractures are reduced through transcutaneous or transconjunctival incisions. But the field of orbital surgery is difficult due to lack of visualization of fracture site, blind dissection of orbital floor, susceptibility of injury of orbital structures. In these situations, the former technique of using an antral balloon catheter has advantages over other methods for reconstruction because of its rapidity, simplicity, and inexpensiveness. Furthermore, the antral balloon catheter allows not only elevation of the orbital bone fragment but also expansion of the maxillary sinus in cases where there is a fracture of its walls. But postoperative follow-up method using computed tomography is expensive. Hence, we report a simple and inexpensive follow-up method using radiopaque dye inflation. Methods: We performed endoscopic transantral approach in 5 cases of blow-out fracture under general anesthesia. To accomplish this technique, a rigid 4 mm, 0 or 30 degree angled endoscopy was inserted into the maxillary sinus. Inflation of the catheter started gradually, with 10 to 15 mL of saline mixed radiopaque dye (saline: dye, 5 : 1) by syringe and while observing the elevation of the fracture site with endoscope until a proper contour was reached. For the maintain of the position of fractured site, 12 French urinary balloon foley catheter were used in fracture site for 7 - 10 days. Results: Postoperative assessment was performed by means of clinical and simple radiographic examination to secure the catheter under the inferior orbital wall and in the maxillary sinus. No specific complications occurred related to this procedure. Results of the surgery and follow-up in all cases were satisfactory. Conclusion: It may be a better alternative to the conventional follow-up method, with less cost and effectiveness of the catheter patency. The advantages of using the urinary balloon foley catheter with the radiopaque dye include the following : it is safe, efficacy, simple, and especially low cost. On drawback of this method is the discomfort to the patient caused by the catheter during the treatment.

• The Korean Journal of Pain
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• 제33권2호
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• pp.176-182
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• 2020

Background: Catheter-related bladder discomfort (CRBD) has been observed in many patients undergoing a urethral catheterization. CRBD may be so severe that the patients require additional analgesics. Muscarinic receptors are involved in the mechanism of CRBD. The aim of this study is to determine the effects of the antimuscarinic properties of atropine, which is frequently used in current practice on CRBD, by comparing it with sugammadex which has no antimuscarinic effects. Methods: Sixty patients selected for transurethral resection due to bladder tumors were randomized into 2 groups: an atropine group and a sugammadex group, with no antimuscarinic effect. The patients were given rocuronium (0.6 mg/kg) as a neuromuscular-blocker. In addition to the frequency and severity of CRBD postoperatively at 0, 1, 6, 12, and 24 hours, postoperative numeric rating scale (NRS) scores, and postoperative nausea and vomiting were examined. Results: The incidence of CRBD was significantly lower in the atropine group in all postoperative measurements. The score was found to be significantly lower in the atropine group when NRS measurements were performed at all time periods (P < 0.01). There was no difference between the groups in terms of nausea and vomiting (P > 0.05). Conclusions: Atropine is a cheap, easy-to-access, safe-to-use drug for reducing CRBD symptoms, without any observed adverse effects. Since it not only reduces CRBD symptoms but also has a positive effect on postoperative pain, it can be used safely to increase patient comfort in patients receiving general anesthesia and a urinary catheter.

• 한국의료질향상학회지
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• 제2권2호
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• pp.156-171
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• 1996

Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.142-146
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• 2017

Purpose: To evaluate changes in quality of life (QoL) in patients with neurogenic bladder treated with clean intermittent catheterization (CIC), who changed from a multiple use catheter (MUC) to single use catheter (SUC). Methods: The Modified Intermittent Self-Catheterization Questionnaire (mISC-Q) was used to determine potential changes in patients' QoL as a result of switching from MUC to SUC. The mISC-Q consists of questions within four categories: ease of use, convenience, discreetness, and symptomatic benefit. Answers were graded as Strongly agree (+2), Agree (+1), Not sure (0), Disagree (-1), and Strongly disagree (-2). Overall patient QoL, as well as by sex, disease (presence of augmentation cystoplasty), and catheterization route (via urethra or urinary diversion), were analyzed. Results: Thirty-eight patients (21M:17F; mean age: $21.7{\pm}5.3y$) submitted questionnaires. For ease of use, SUC was significantly better than MUC (score: 0.364, P=0.002) in all patients. Patients with catheterization via the urethra showed significant favor for SUC in ease of use (score: 0.512, P<0.001) and convenience (score: 0.714, P=0.011), but patients with catheterization via the abdominal stoma of urinary diversion gave negative scores in all categories, though no categories were significant. Conclusion: This study suggested that changing from MUC to SUC may lead to improvements in QoL, especially regarding ease of use. This benefit was clearly found in patients with catheterization via urethra rather than abdominal stoma of urinary diversion.

• 대한두개안면성형외과학회지
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• 제16권3호
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• pp.114-118
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• 2015

Background: The reduction of orbital blowout fracture primarily aims to normalize the extra-ocular movement by returning the herniated orbital soft tissue into the original position, and to prevent enophthalmos by normalizing the orbital cavity volume. We introduce a balloon catheter-assisted orbital floor reduction technique. Methods: A retrospective review was performed for all patients with orbital floor fracture who underwent the technique described in the main body of this text. Medical records were reviewed for demographic data, clinical presentation and course, degree of enophthalmos, intraorbital volume on computed tomography scan, and postoperative outcomes. The enophthalmos and intraorbital volume of the injured site were compared to the uninjured eye and orbit. Results: The review identified 14 patients (11 male, 3 female). The mean preoperative difference in en-exopthalmos was 2.13 mm, while the mean orbital volume was 116%. The mean postoperative difference in en-exophthalmos had improved to 0.61 mm with a mean orbital volume of 101.85%. At the time of catheter removal at 10 days, three patients experienced diplopia (n=1), extra-ocular movement disorder (1), or enophthalmos (1). All of these had resolved by the 6-month follow-up visit. Conclusion: Balloon catheter-assisted reduction of the orbital floor fractures was associated with improvements in intraorbital volume and enopthalmos in the 14 patients. Notable complications included diplopia, enophthalmos, and limited extra-ocular movement, all of which were transient in the early postoperative period and had resolved by 6-month follow up.

• 임상간호연구
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• 제29권3호
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• pp.211-222
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• 2023

Purpose: This study was conducted to update the existing evidence-based nursing clinical practice guideline for indwelling urinary catheterization (IUC). Methods: The guideline have been revised in 22 steps based on international standards. The quality of the practice guidelines to be used for revision was evaluated using the Appraisal of Guidelines for Research and Evaluation II. The evaluation of the content appropriateness and applicability of the draft recommendations of the revised practice guidelines was performed using the RAND/UCLA Appropriateness Method, a decision-making method developed by the RAND Corporation. Four guidelines were used for the revision. Results: The updated nursing practice guideline for IUC consisted of 9 domains and 134 recommendations. The numbers of recommendations in each domain were: 4 Assessment, 20 Equipment, 11 Catheter insertion, 52 Catheter maintenance, 4 Catheter and drainage bag change, 9 Catheter removal, 22 Complications management, 5 Education and consult, and 7 Hospital support. The recommended grade was 8.2% for A, 38.1% for B, and 53.7% for C. Among these, the major revision was done in 11 recommendations (8.2%). A total of 29 recommendations (21.6%) were newly added. 30 (22.4%) recommendations had minor revisions such as changes or addition for some words or sentences, and 13 (9.7%) recommendations were deleted. Conclusion: Revised nursing practice guideline is expected to serve as an evidence-based practice guideline for IUC in Korea. This guideline will provide health care providers, patients, and caregivers with information to help manage IUC, leading to improved patient outcomes.

• 간호행정학회지
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• 제20권1호
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• pp.128-143
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• 2014

Purpose: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. Methods: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. Results: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. Conclusion: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.

• 간호행정학회지
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• 제21권1호
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• pp.64-76
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• 2015

Purpose: To implement evidence-based nursing, it is important to know where and how to find the best available evidence. This study was conducted to identify the results of a search from Ovid MEDLINE and to compare the results from Ovid MEDLINE with those from PubMed MEDLINE. Methods: Four different approaches via Ovid MEDLINE were used to search for guidelines on preventing catheter-associated urinary tract infections. Outcomes of this study were the number of records and relevant literature, and the sensitivity and precision of the search methods via Ovid MEDLINE. Results: The number of retrieved items ranged 23 to 6,005 and that of relevant studies, 5 to 8 of 8. Simple searches resulted in the highest sensitivity of 100.0%. When using MeSH terms and limits feature, the precision was highest (21.7%) among four approaches for literature searches. Simple searches in Ovid had higher sensitivity and lower precision than those in PubMed. Conclusion: Simple searches in Ovid may be inefficient for busy clinicians compared to PubMed. However, to ensure a comprehensive and systematic literature search, using Ovid MEDLINE in addition to PubMed is recommended.