Departments of, Department of, Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.
Department of, Crisis Medicine and Patient Safety, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.
Int J Urol. 2021 Jun;28(6):645-649. doi: 10.1111/iju.14528. Epub 2021 Feb 24.
To analyze incidents related to Foley catheter insertion and maintenance, and to compare the rate of incidents before and after a medical staff education program.
Data regarding Foley catheter insertion incidents and maintenance were collected at Toyama University Hospital, Toyama, Japan. The degree of harm for each incident was assessed. In the middle of the study period, a medical staff education program by urologists was implemented to help understand basic urological anatomy, urethral catheter insertion techniques and catheter safety. The incidents before and after the intervention were then compared.
During the study period, Foley catheter insertion was carried out in 12 476 patients. Related incidents were reported in 66 (0.53%), including 22 (0.18%) occurring during catheter insertion and 44 (0.35%) occurring during catheter maintenance. A total of 13 (0.10%) cases of urethral injury were reported. The degree of harm associated with catheter insertion incidents was moderate in 13. Nine of these incidents occurred before the education program (9/6799, 0.13%), and four were reported after the end of the program (4/5677, 0.07%, P = 0.4303). Transient suprapubic cystostomy was required in two due to urethral injury reported before the program. Among 44 incidents occurring during catheter maintenance, 37 catheters were removed or cut by the patient. Such incidents occurred regardless of the education program.
The rate of incidents related to Foley catheter use at our institution is low. A specific medical staff education program might prevent iatrogenic catheter-related urethral injury requiring cystostomy.
分析与 Foley 导管插入和维护相关的事件,并比较医护人员教育计划前后的事件发生率。
在日本富山大学医院收集与 Foley 导管插入和维护相关的事件数据。评估每个事件的伤害程度。在研究期间的中间,泌尿科医生实施了一项医护人员教育计划,以帮助了解基本的泌尿科解剖结构、尿道导管插入技术和导管安全性。然后比较干预前后的事件。
在研究期间,12476 名患者进行了 Foley 导管插入。报告了 66 起相关事件(0.53%),包括 22 起(0.18%)在导管插入过程中发生和 44 起(0.35%)在导管维护过程中发生。总共报告了 13 起(0.10%)尿道损伤病例。导管插入事件相关伤害程度为中度的有 13 起。这些事件中有 9 起发生在教育计划之前(9/6799,0.13%),有 4 起发生在计划结束后(4/5677,0.07%,P=0.4303)。由于报告在计划之前的尿道损伤,有 2 人需要进行暂时性耻骨上膀胱造口术。在 44 起导管维护过程中发生的事件中,37 根导管被患者拔出或剪断。这些事件无论是否进行教育计划都可能发生。
本机构与 Foley 导管使用相关的事件发生率较低。特定的医护人员教育计划可能会预防需要膀胱造口术的医源性导管相关尿道损伤。