Authors (including presenting author) :
Wong SW Arale(1), Chan CM (1), Chung YY(1), Cheng Elaine(2), Sha KY Edmund(2)
Affiliation :
(1) Continence Nurse Clinic (2) Department of Geri-medical, United Christian Hospital, KEC, HA
Introduction :
Acute Retention of Urine (AROU) is commonly noted in geriatric patients, the associated factors included constipation, urinary tract infection and post operative analgesic effect secondary to fracture reduction operations. In United Christian Hospital Continence Nurse Clinic, most of the elderly patients with AROU were referred from Orthopedic & Geriatric wards during their hospitalization. Annual review of the patients’ data was done and specific trail of wean off urinary catheter (TWOC) management plan was formulated for better quality care.
Objectives :
To review AROU in-patient’s data with related management who was referred for TWOC
Methodology :
Retrospective study was done to review the causes of AROU, TWOC episodes and management outcomes. The data was collected from January to December, 2021. Information was obtained from in-patient consultation note in Clinical Management System.
Result & Outcome :
Total 190 patients with AROU and being inserted for urinary catheter were reviewed, there were 155 female and 35 male patients with average age 81.3. Most of the patients were referred from Orthopedic department (82.6%) & remaining referrals were made from Geri-medical department. It was noted 45.8% of patients underwent general & spinal anesthesia orthopedic operation, 42% with urinary tract infection and 71% with fecal loaded bowel shown in X-ray. And 60% of patients developed AROU within four days since admission. 96.3% of patients had trail 1st TWOC at day 8 from first day of AROU with successful rate (SR) around 21.1%, 75.3% of patients had trail 2nd times TWOC at day 15 from first day of AROU with higher SR 32.6%, and 42.6% of patients had trail 3rd times or above TWOC at day 28 onward from first day of AROU with similar SR 31.6% compared to the 2nd times trail of TWOC. The contributing factors associated AROU in elderly patients which addressed in this study are enviable, to optimize unnecessary TWOC and achieve higher successful rate of TWOC, it is better to treat the associated underlying causes like constipation & urinary tract infection before consider TWOC. Moreover, it is better to consider TWOC at day 15 instead of too early TWOC.
