Authors (including presenting author) :
Fan YSJ(1), King J(1), Fung HY(1), Taylor D(1), Lau KW(1), Cheon WC(1), Ng CW(1)
Affiliation :
(1)Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital
Introduction :
Female urinary retention is common in obstetrics and gynecology. At Queen Elizabeth Hospital's Gynecology Department, patients unable to void post-Foley catheter removal were assessed by urogynecology nurses and taught Clean Intermittent Self-Catheterization (CISC). Due to limited nurse availability, patients faced delays.
Objectives :
1. To empower ward staff to teach high-quality CISC. 2. To enable prompt initial assessment and intervention for AROU, without the delays in waiting for urogynaecology nurse. 3. To reduce the length of hospital stay. 4. To reassess patients for ensuring the quality and effectiveness of the CISC procedure taught. 5. To collect staff feedback for satisfaction and programme effectiveness.
Methodology :
A retrospective review included patients needing CISC and staff participating in the CISC-TTT program from the gynecology and postnatal wards. Patient records from January 2021 to November 2023 were examined. Ward staff feedback was collected via a questionnaire in October 2023.
Result & Outcome :
Out of 48 patients, 39 received traditional care and 9 underwent early CISC training by ward staff. We compared consultation times and duration of CISC training pre- and post-CISC-TTT program implementation. Results showed a reduction in mean waiting time for assessment from 11.3 to 7.2 hours, and CISC proficiency time dropped from 2.48 to 1.38 days. No CISC-TTT program patients required a long-term Foley catheter. Phone follow-ups by nurses increased from 1.59 to 3.33 times, while post natal ward visits decreased slightly from 2.14 to 2.00 times. Time spent on post natal ward visits dropped significantly from 141.59 to 95.71 minutes. The decreased wait times and quicker CISC proficiency indicate the CISC-TTT program's effectiveness. The program also led to a shorter hospital stay. However, increased phone follow-ups and fewer ward visits suggest a need for more post-intervention patient assessment and monitoring. Ward nurses reported greater satisfaction and positive feedback on their involvement in the program. The train-the-trainer initiative has effectively empowered ward staff in managing urinary retention, enhancing patient care and staff engagement, and promoting better patient outcomes.
