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使用移动即时护理应用程序预防被遗忘的输尿管支架

Preventing the Forgotten Ureteral Stent by Using a Mobile Point-of-Care Application.

作者信息

Ziemba Justin B, Ludwig Wesley W, Ruiz Leticia, Carvalhal Eduardo, Matlaga Brian R

机构信息

1 Department of Urology, Brady Urological Institute , Johns Hopkins School of Medicine, Baltimore, Maryland.

2 Department of Urology, Hospital Punta Pacifica , Panama City, Panama .

出版信息

J Endourol. 2017 Jul;31(7):719-724. doi: 10.1089/end.2017.0118. Epub 2017 May 15.

Abstract

INTRODUCTION

The forgotten ureteral stent (FUS) can lead to patient morbidity. To date, tracking ureteral stents is a cumbersome task, given their high frequency of insertion and variable indwelling times. To simplify this process, an application was developed to track patients with indwelling ureteral stents. We report our initial user experience and clinical outcomes with this application.

METHODS

Ureteral Stent Tracker™ (UST) is a secure, Health Insurance Portability and Accountability Act (HIPPA)-compliant, cloud-based point-of-care application. It is designed for logging stent insertion, scheduling the date of anticipated stent extraction, and confirming stent removal. It is accessible via a mobile phone application or web browser interface. We consecutively enrolled all patients who underwent ureteral stent insertion for any indication by two urologists from January 10, 2015, to October 10, 2016. A retrospective chart review was performed of all patients included in the UST database. Data extracted included patient demographics, diagnosis, procedure, and stent characteristics.

RESULTS

A total of 115 patients were included with a mean age of 52.4 years; 54% (62/115) were male and 58% (67/115) were Caucasian. This cohort represented 146 ureteral stent care plans with 23 patients (23/115; 20%) having more than one care plan during the study period. The most common procedure performed was ureteroscopy (70/146; 48%) for a diagnosis of nephrolithiasis (108/146; 74%). The median indwelling ureteral stent time was 14 days (interquartile range: 7-45 days). A total of three patients (3/115; 3%) did not return for their scheduled extraction, but were identified only through the application. Each patient was contacted, resulting in effective removal of all three stents in the office.

CONCLUSIONS

Tracking of ureteral stents is critical to prevent the patient safety issue of the FUS. The UST is a secure, HIPPA-compliant, cloud-based application, which once incorporated into the workflow of a urologic practice can prevent the FUS.

摘要

引言

被遗忘的输尿管支架(FUS)可导致患者发病。迄今为止,鉴于输尿管支架置入频率高且留置时间各异,追踪输尿管支架是一项繁琐的任务。为简化这一过程,我们开发了一款应用程序来追踪留置输尿管支架的患者。我们报告了使用该应用程序的初步用户体验和临床结果。

方法

输尿管支架追踪器™(UST)是一款安全的、符合《健康保险流通与责任法案》(HIPPA)的基于云的即时医疗应用程序。它旨在记录支架置入情况、安排预期的支架取出日期并确认支架取出。可通过手机应用程序或网页浏览器界面访问。我们连续纳入了2015年1月10日至2016年10月10日期间由两位泌尿科医生因任何适应症进行输尿管支架置入的所有患者。对UST数据库中纳入的所有患者进行了回顾性病历审查。提取的数据包括患者人口统计学信息、诊断、手术及支架特征。

结果

共纳入115例患者,平均年龄52.4岁;54%(62/115)为男性,58%(67/115)为白种人。该队列代表146个输尿管支架护理计划,23例患者(23/115;20%)在研究期间有不止一个护理计划。最常见的手术是输尿管镜检查(70/146;48%),诊断为肾结石的患者有108例(108/146;74%)。输尿管支架的中位留置时间为14天(四分位间距:7 - 45天)。共有3例患者(3/115;3%)未按计划返回取出支架,但仅通过该应用程序才被发现。与每位患者取得联系后,在办公室成功取出了所有3个支架。

结论

追踪输尿管支架对于预防FUS这一患者安全问题至关重要。UST是一款安全的、符合HIPPA的基于云应用程序,一旦纳入泌尿外科实践工作流程,即可预防FUS。

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