Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
CHUNG YY (1)
WONG SW, Arale (1)
Lam KM (2)
SO HS (2)
Affiliation :
Continence Care Services, 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 Foley 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 nurses. It was a co-joint program with Accident and Emergency Department (AED) which was established in 2013 in United Christian Hospital SOPD that focused on patients with AUR. In June 2021, enhancement program was implemented to provide on- site consultation which enhance better Foley care management in order to facilitate the early trial wean off Foley catheter (TWOC)
Objectives :
-To reduce unnecessary hospital admission
-To reduce the hospital cost
-To reduce doctor workload
-To facilitate early TWOC
-To reduce the incidence Foley catheter associated complications
-To optimize arrangement for follow up
Methodology :
Retrospective study was retrieved from Clinical Management System of AUR cases referred by ED between January 2021 and November 2022.
Result & Outcome :
Total 531 AUR patients were reviewed, there were 33 female and 498 male patients with average age 73. Those patients were assessed by continence nurse at AED with Foley care education about Foley fixation, bowel management, fluid regime, medications and bladder diary record. Those patients did not need admission to Urology wards. They were home with Foley catheter and reassessed at CCC within 4 days after discharge from AED. Those AUR patients were referred to Urology SOPD with waiting time 8-10 weeks.．
At CCC, patients can TWOC in average 9 days which was 2 times faster compared to 17 days TWOC by community nurse and 5 times faster compared to 48 days TWOC by Urology Team. Total 424 patients (80%) TWOC successfully and 107 patients (20%) need further management like operation, intermittent catheterization or keep long term Foley catheter.
Continence nurse provided on-site AED consultation could arrange early TWOC and reduce unnecessary hospital admission in order to reduce the hospital cost. Early successful TWOC could reduce Foley catheter associated complications and greatly enhance patients’ quality of life and body image
