膀胱刺激法在清洁中段尿采集法中的应用：提高了家长和医护人员的满意度。

Bladder Stimulation for Clean Catch Urine Collection: Improved Parent and Provider Satisfaction.

机构信息

From the Division of Pediatric Emergency Medicine, Department of Pediatrics.

Children's Research Center of Michigan, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI.

出版信息

Pediatr Emerg Care. 2022 Jan 1;38(1):e29-e33. doi: 10.1097/PEC.0000000000002524.

DOI:10.1097/PEC.0000000000002524

PMID:34475366

Abstract

OBJECTIVES

Previous studies have demonstrated the efficacy of fluid intake with suprapubic and lumbar paravertebral massage for clean catch urine (CCU) collection in infants. We investigated the acceptability and feasibility of integrating this bladder stimulation technique (BST) into routine care in the pediatric emergency department (PED).

METHODS

This was a prospective cohort study. Infants less than 6 months of age requiring a urinalysis and urine culture as part of their PED visit were recruited. All PED nurses and technicians received a standardized training outlining the BST using a video module and print materials. Success rates, bacterial contamination, parental perception of patient distress, and parent and provider satisfaction with the BST for CCU collection were compared with urethral catheterization.

RESULTS

A total of 124 patients were recruited. The BST was successful in 38% (47/124) with a median time to void of 73 seconds (interquartile range: 19, 151). The BST was more likely to be successful in infants less than 90 days (53%; 95% confidence interval, 0.075-0.046; P = 0.005). A urinary tract infection was diagnosed in 4% of patients, with no significant differences between BST (1/47; 2%) and catheterization (4/59; 7%; P = 0.65). Patients experienced less discomfort during the BST compared with catheterization (mean numeric rating scale score, 2/10 vs 6/10; P < 0.001), and the BST was viewed positively by both parents and providers. Compared with catheterization, parents were significantly more satisfied with the BST (BST, 98%; catheterization, 58%; P < 0.001) and were more likely to consent to the BST in the future (BST, 98%; catheterization, 69%; P < 0.001). Most providers reported that the BST was well tolerated by participants (46/47; 98%), and providers felt that the BST improved parental satisfaction with the clinical encounter (46/47; 98%).

CONCLUSION

The BST for CCU collection is a well-tolerated and well-received approach that can easily be implemented into clinical practice with minimal training.

摘要

目的

先前的研究已经证明了耻骨上和腰椎旁椎体按摩联合导尿术在收集清洁中段尿（CCU）方面对婴儿的有效性。我们研究了将这种膀胱刺激技术（BST）整合到儿科急诊部门（PED）常规护理中的可接受性和可行性。

方法

这是一项前瞻性队列研究。招募了在 PED 就诊时需要进行尿液分析和尿液培养的年龄小于 6 个月的婴儿。所有 PED 护士和技术员都接受了一项标准化培训，该培训使用视频模块和印刷材料概述了 BST。比较了 BST 与尿道插管在收集 CCU 时的成功率、细菌污染、家长对患儿不适的感知，以及家长和提供者对 BST 的满意度。

结果

共招募了 124 名患者。BST 成功 38%（47/124），中位排尿时间为 73 秒（四分位距：19，151）。BST 在小于 90 天的婴儿中更有可能成功（53%；95%置信区间，0.075-0.046；P=0.005）。4%的患者被诊断为尿路感染，BST（1/47；2%）和导管插入术（4/59；7%；P=0.65）之间无显著差异。与导管插入术相比，患者在 BST 过程中感到的不适较少（平均数字评分量表评分，2/10 与 6/10；P<0.001），BST 受到家长和提供者的积极评价。与导管插入术相比，家长对 BST 的满意度显著更高（BST，98%；导管插入术，58%；P<0.001），并且更有可能同意未来使用 BST（BST，98%；导管插入术，69%；P<0.001）。大多数提供者报告说，参与者对 BST 的耐受性良好（47/47；98%），并且提供者认为 BST 提高了家长对临床就诊的满意度（47/47；98%）。