venerdì 11 gennaio 2013


Proposta di linee guida attraverso l'analisi della letteratura ed una consensus conference per prevenire danni iatrogeni al paziente attraverso l'uso dell'ecografia per monitorizzare l'eventuali ritenzioni urinarie ed utilizzare il cateterismo solo quando serve

 2012 Aug 30. doi: 10.1111/j.1365-2702.2012.04229.x. [Epub ahead of print]

Guidelines for preventing urinary retention and bladder damage during hospital care.


Authors: Rose-Marie Johansson, RN, PhD Student, School of Health Sciences, Jönköping University, Jönköping; Bo-Eric Malmvall, MD, Professor, Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Linköping University, Linköping and Futurum - The Academy of Healthcare, County Council, Jönköping; Boel Andersson-Gäre, MD, Professor, Futurum - The Academy of Healthcare, County Council and Jönköping Academy for Improvement of Health and Welfare, School of Health Sciences, Jönköping University; Bruno Larsson, MD, Urologist, Unit of Urology, County Hospital Ryhov, Jönköping; Ingrid Erlandsson, RN, Developement Officer, Unit of Urology, County Council Ryhov, Jönköping; Märta Sund-Levander, RN, RNT, PhD, Assistant Professor, Unit of Research and Development, Hoegland Hospital, Eksjö; Gunhild Rensfelt, RN, Infection Control Nurse, Infection Control, County Hospital Ryhov, Jönköping, Sigvard Mölstad, MD, Professor, Unit of R&D in Primary Care, Futurum, Jönköping, Lennart Christensson, RN, Associate Professor, School of Health Sciences, Jönköping University Jönköping, Sweden.


Aims and objectives.  To develop evidence-based guidelines for adult patients in order to prevent urinary retention and to minimise bladder damage and urinary tract infection. Background.  Urinary retention causing bladder damage is a well known complication in patients during hospital care. The most common treatment for urinary retention is an indwelling urinary catheter, which causes 80% of hospital-acquired urinary tract infections. Appropriate use of bladder ultrasonography can reduce the rate of bladder damage as well as the need to use an indwelling urinary catheter. It can also lead to a decrease in the rate of urinary tract infections, a lower risk of spread of multiresistant Gram-negative bacteria, and lower hospital costs. Design.  An expert group was established, and a literature review was performed. Methods.  On the basis of literature findings and consensus in the expert group, guidelines for clinical situations were constructed. Results.  The main points of the guidelines are the following: identification of risk factors for urinary retention, managing patients at risk of urinary retention, strategies for patients with urinary retention and patient documentation and information. Conclusion.  Using literature review and consensus technique based on a multiprofessional group of experts, evidence-based guidelines have been developed. Although consensus was reached, there are parts of the guidelines where the knowledge is weak. Relevance to clinical practice.  These guidelines are designed to be easy to use in clinical work and could be an important step towards minimising bladder damage and hospital-acquired urinary tract infections and their serious consequences, such as bacteraemia and the spread of multidrug-resistant bacteria in hospitals.
© 2012 Blackwell Publishing Ltd.