Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
WONG SWA(1), WONG YM(1), LAM WS(1), CHAN CM(1), CHUNG YY(1)
Affiliation :
(1) Continence Nurse Clinic, United Christian Hospital, KEC, HA
Introduction :
Continence nurse majority responsible for early management of geriatric patients’ urethral catheter (UC), these patients with reversible causes of retention of urine (ROU) required transient urine drainage by UC, to preserve individual’s quality of life and prevent UC associated complications, a tailor-made TWOC plan designed by specialty nurse is essential to achieve optimal outcomes to patients
Objectives :
To review background, causes of ROU and TWOC outcomes among geriatric patients in three hospitals in KEC
Methodology :
Retrospective study was done for geriatric patients who had been referred to continence nursing team for in-patient TWOC from 1st Jan to 31st Dec, 2022. The underlying causes, residue urine volume, TWOC successful rate and ultimate management plan were reviewed and data were compared among KEC three hospitals
Result & Outcome :
Total 280 patients’ data were reviewed, 68% (N=190) from United Christian Hospital (UCH), 24% (N=66) from Tseung Kwan O Hospital (TKOH) and 9% (N=24) from Haven of Hope Hospital (HHH) were noted. The main underlying causes among UCH patients were constipation (73.2%), post operative anesthetic effect (45.8%) & urinary tract infection, UTI (42%). In TKOH, the causes were UTI (86.4%) & constipation (58%). In HHH, the causes were UTI (75%), constipation (58%) & non-specific reason (8.3%). The average residue urine before UC insertion among three hospitals’ patients was 670ml.Overall successful TWOC rate were 85.3%, 57% & 45.8% among UCH, TKOH & HHH respectively. For patients required long-term UC, the rate was 3.7%, 19.7% & 41.7% accordingly. In conclusion,varies underlying cause of ROU among three hospitals’ patients, constipation and UTI are the main reasons causing ROU. For UTI associated ROU, lower successful TWOC rate was noted compared to constipation associated ROU. And the results also compactible with hospitals’ setting. For acute hospital such as UCH & TKOH, higher successful TWOC rate was being noted when compared to convalescent HHH. It may also due to patients’ primary disease prognosis and declined physical condition among HHH patients. Further exploration on TWOC management could be done for non-acute setting hospital patients for outcomes improvement
