Reid, Victoria, BSN,RN

Rivera Garcia, Genesis, BSN,RN

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Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingUrinary Retention Protocol (Poster).Genesis Rivera Garcia BSN,RNLehigh Valley Health Network, Genes_S.Riveragarcia@lvhn.orgVictoria Reid BSN,RNLehigh Valley Health NetworkFollow this and additional works at: https://scholarlyworks.lvhn.org/patient-care-services-nursingPart of the Nursing CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtRivera Garcia, G. Reid, V, (2017, February). Urinary Retention Protocol. Poster presented at: LVHN Vizient/AACN Nurse ResidencyProgram Graduation, Lehigh Valley Health Network, Allentown, PA.© 2014 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaUrinary Retention Protocol  • Observations identified opportunities for staff to promote avariety of interventions to stimulate voiding prior to resortingto straight catheterization. A pre-implementation surveyidentified a knowledge deficit regarding interventions topromote voiding in patients at risk for acute urinary retention.• (P) Population: Patients at risk for acute urinary retentionpost-operatively following catheter removal and, patients witha history of urinary retention.• (I) Interventions:• Design and utilize a visual cue card titled, the “Clock PieChart,” which identifies interventions to promote voiding• Educate staff about interventions, which then are to beshared with patients• (C) Comparison: Incorporation of the Clock Pie Chartinterventions within the current Urinary Retention Protocol(s)versus non-incorporation.• (O) Outcomes:• Increase staff knowledge of nursing interventions to promotevoiding• Decrease the amount of straight catheterizations.Darrah, D., & Griebling, T. (2016). Postoperative Urinary Retention. ClinicalKey.com. Pages 465-484.Perry, A., Potter, P., and Stocker, P. (2013). Fundamentals of Nursing, 8 th Edition. Elsevier Inc: Mosby.Ruhl, M. (2016). Postoperative Voiding Criteria for Ambulatory Surgery Patients. Elsevier Inc. pages 871-874. • Urinary retention is traditionally treated with anindwelling urethral catheter or intermittentcatheterization. (Johansson, et al, 2010)• Urethral catheterization is connected with risk ofcomplications such as urinary tract infection(UTI), trauma, urethral perforation, stricture,bleeding, fistula and increases in discomfort.(Johansson, et al, 2010)• Once a catheter enters the bladder, the incidenceof bacteriuria rises by about 3-7% per day.(Johansson, et al, 2010)• In many clients, when interventions are utilized todecrease the amount of residual urine, it caneventually lead to the tapering of catheterization.(Carpenito-Moyet, 2004, pg. 366-371)Straight Catheterizations  13 (34%)Patients not requiring catheterization25 (66%)Genesis Rivera Garcia BSN,RN and Victoria Reid BSN,RNBackgroundLiteratureConclusionReferencesResultsNumber of Straight CatheterizationsPRE-INTERVENTIONStraight  Catheterizations 4 (20%)Patients not requiring catheterization16 (80%)Post-interventions  n=20 fluidstoiletingconsult urologybladder scan protocolStraight Catheterizations 21 (57%)running waterambulation massagePre-education n=37fluidstoiletingconsult urologybladder scan protocolStraight Catheterizations 11 (24%)running waterambulationmassagePost-education n=46INTERVENTIONS POST-INTERVENTIONStaff survey regarding knowledge of interventions to promote voiding in patients at risk & with history for acute urinary retentionStaff education via huddles, e-mails & postersStaff survey regarding knowledge of interventions to promote voiding in patients at risk for & with history of acute urinary retention. Patient Education of interventions by nurse caring for patientUrinary Retention Clock Pie Chart• Following staff education regarding the ClockPie Chart, more interventions were utilized andthe number of straight catheterizationsdecreased.Design of the Urinary Retention Clock Pie ChartPre-interventions n=38Interventions Utilized

Urinary Retention Protocol (Poster).

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1857&context=patient-care-services-nursing

Urinary Retention Protocol (Poster).

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