Bacha Syed Haseeb Ullah Jan, Babar Saman, Khan Muhammad Hamza, Hameed Shawal
Medicine, East Sussex Healthcare National Health Service Trust, East Sussex, GBR.
Physiology, Abbottabad International Medical Institute, Abbottabad, PAK.
Cureus. 2024 Nov 7;16(11):e73243. doi: 10.7759/cureus.73243. eCollection 2024 Nov.
This editorial highlights the importance of catheterisation documentation and the practice of trials without catheters in improving patient outcomes in Pakistan. Acute urinary retention, a major urological emergency, needs short-term catheter placement, with a trial without a catheter used globally to reduce catheter-associated urinary tract infections. This procedure, often enhanced by alpha-1 blockers, enables patients to regain continence and promotes micturition post-catheterisation, particularly useful following surgeries such as prostatectomy. However, trials without catheters remain underutilised in Pakistan, particularly outside urology departments, potentially leading to severe complications such as acute renal failure and urosepsis. Accurate documentation of catheterisation details, including catheter size, insertion time, clinical indications, and any complications, is paramount for minimising risks and improving continuity of care. A clinical audit led by Dr. Syed Haseeb Ullah Jan Bacha at Eastbourne District General Hospital highlighted critical gaps in catheterisation documentation, revealing lapses in recording crucial parameters like bladder scan volumes and staff names. Recommendations from the audit, including educational interventions and system improvements, necessitate the need for precise record-keeping, a practice standard in the United Kingdom but lacking in Pakistan. Introducing trial without catheter (TWOC) and documentation practices can elevate patient safety and foster a culture of continuous improvement in Pakistan's healthcare system.
这篇社论强调了导尿记录以及无导尿管试验在改善巴基斯坦患者治疗效果方面的重要性。急性尿潴留是一种主要的泌尿外科急症,需要短期放置导尿管,全球普遍采用无导尿管试验以减少导尿管相关的尿路感染。该程序通常借助α-1阻滞剂得到加强,能使患者恢复控尿能力,并促进导尿后排尿,在前列腺切除术等手术后尤为有用。然而,无导尿管试验在巴基斯坦仍未得到充分利用,尤其是在泌尿外科以外的科室,这可能导致诸如急性肾衰竭和尿脓毒症等严重并发症。准确记录导尿细节,包括导尿管尺寸、插入时间、临床指征以及任何并发症,对于将风险降至最低并改善护理连续性至关重要。由伊斯特本地区综合医院的赛义德·哈西卜·乌拉·扬·巴查博士主导的一项临床审计突出了导尿记录中的关键差距,揭示了在记录膀胱扫描容量和工作人员姓名等关键参数方面的失误。审计提出的建议,包括教育干预和系统改进,凸显了精确记录的必要性,这在英国是一种实践标准,但在巴基斯坦却有所欠缺。引入无导尿管试验(TWOC)和记录做法可以提高巴基斯坦医疗系统中的患者安全,并促进持续改进的文化。