Authors (including presenting author) :
CHUNG YY(1), WONG SW Arale(1), CHAN YC(2) , LAM KM(2), SO HS(2)
Affiliation :
Continence Care Service, Nursing Services Division, United Christian Hospital
Introduction :
Acute urinary retention (AUR) is the common urological emergency which can cause great discomfort, pain or even harm to the kidney function. It should be managed by catheterization. Patient with Foley catheter can greatly affect their quality of life and had a negative impact on body image.
Catheter Care Clinic (CCC) is a nurse clinic run by continence nurse. An enhancement program with Accident & Emergency Department (AED) commenced in June 2021 to provide on-site AED continence nurse consultation for AUR patients.
Objectives :
-To reduce unnecessary hospital admission
-To provide early TWOC
-To provide one -stop services for patient assessment to improve quality and increase
efficiency
-To optimize arrangement for follow up
Methodology :
AED recruited AUR patients fulfilled the criteria and referred them directly to CCC. Blood taking and abdominal X ray were done and Foley catheter were inserted at AED. Continence nurse provide on-site AED consultation with comprehensive assessment and physical examination. Tailor-made nursing management e.g. fluid intake regime, proper Foley fixation, bowel management, medication, Foley care and bladder dairy were taught. Moreover, Community nurse (CN) was referred for Foley care at home and urologist was referred for further operation or investigations. AED doctors also prescribed alpha -blocker. After assessment by continence nurse at AED, patients were reminded to attend the CCC within 7 days. Then patients would be discharged with Foley catheter.
At CCC at SOPD, patients were assessed for TWOC. They could TWOC at CCC or by CN at home. For those failed TWOC or keep Foley catheter till urology follow up will be no longer follow up at CCC. They waited for around 8-10 weeks for Urology appointment.
Total 307 patients were referred to CCC from Nov 2021 to Nov 2022.The average age was 73.2. 62.5% (N=192) received on site continence nurse consultation at AED. Average waiting time for patient to attend CCC was 3.3 days. Patients arranged for TWOC in CCC in average 9 days which was 2 times faster compared to 17 days TWOC by CN and 5 times faster compared to 48 days TWOC by Urology Team. Finally, 77.5% (N=240) patients could TWOC successfully and 22.5% (N=69) patients need other management.
Result & Outcome :
Continence nurse provided on-site AED consultation could arrange early TWOC and greatly reduce unnecessary hospitalization. Early successful TWOC could improve patients’ quality of life and body image.
