Urologic Nursing

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Catheter-associated urinary tract infections (CAUTIs) are one of the most common hospital-acquired infections in the United States. Because of persistently high CAUTI rates despite evidence-based interventions, we designed and implemented a performance improvement nurse-driven removal protocol for indwelling urinary catheters. Post-implementation, both catheter utilization and CAUTIs decreased significantly at the one hospital with the highest baseline rates; at the two hospitals with low baseline rates, the impact of the protocol varied...

This health economic evaluation simulated a cohort to compare hydrophilic-coated to non-coated catheters for intermittent catheterization. By using a Markov model, lifetime costs and catheter-related complications were investigated. Results determined that the use of hydrophilic-coated catheters save money and reduce treatment-related complications.

In the United Kingdom, our Health Needs Assessment survey return rate of 42% identified unmet needs in subjects with prostate cancer. Subjects reported the greatest unmet need was related to erectile dysfunction. Other unmet needs were related to incontinence, tiredness, hot flashes, lower urinary tract symptoms, rectal bleeding, and relationship issues.

Urinary incontinence (UI), typically a sensitive and personal concern, has been amendable to healthcare interventions via telehealth applications. Telehealth has been identified as a method capable of providing care to rural locations based on its ability to eliminate the need for patient and/or healthcare provider travel. The purpose of this project was to determine if telehealth improved follow-up visit rates among rural dwelling patients with UI. Additional data were collected to assess the effect of treatment recommendations, patient perception of this experience, and healthcare team opinion of telehealth implementation...

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The Braden scale is a widely used tool to assess pressure ulcer risk. Preoperative Braden scores were significantly associated with postoperative morbidity among women undergoing urogynecologic surgery for stress incontinence and pelvic organ prolapse.

The Society of Urologic Nurses and Associates (SUNA) and the American Urological Association (AUA) collaborated to develop a standard operating procedure in 2015 for instillation of intravesical cytotoxic, immunotherapeutic, and/or therapeutic drugs for patients with urothelial carcinoma of the bladder and interstitial cystitis. This is a synthesis of the standard operating procedure in the context of hazardous drug administration, including indications for administration, guidelines, and principles of hazardous drugs in the clinical setting, peri-treatment concerns, and patient and staff education...

Transrectal ultrasound guided biopsy of the prostate remains the gold standard investigation to diagnose prostate cancer. Although post-biopsy complications are relatively rare, the risk of sepsis associated with the procedure means that prophylactic antibiotics are paramount. The most widely used antibiotic regimen includes a quinolone, such as ciprofloxacin. Resistance to quinolone antibiotics is rising. In this small pilot study, the incidence of quinolone resistance was 18% in our population of patients attending the prostate biopsy clinic...

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This article describes the analysis of the concept of health seeking in men. Men have shorter life expectancies and utilize health services less often than women, leading to poor health outcomes, but a gendered basis for health seeking remains poorly defined. Walker and Avant’s framework was used to guide this concept analysis. Literature published in English from 1990-2015 was reviewed. Thematic analysis identified attributes, antecedents, and consequences of the concept. Based on the analysis, a contemporary definition for health seeking in men was constructed, rooted in the concept of health...

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A qualitative-descriptive study of four patients with prostate cancer used the Cognitive-Social Health Information Processing framework to understand how and why men diagnosed with prostate cancer choose active surveillance over other treatment options. In accordance with the literature, it was found that the surgeon or general practitioner's recommendation was the most influential factor when patients are making a treatment decision.

In radical cystectomy, under-nutrition is common and has detrimental physiological and clinical effects, which can lead to increased complications and prolonged recovery. This article compares measurements and outcomes across continents in this patient population with advanced bladder cancer. The association of preoperative nutritional risk, nutritional status, and length of stay is equal across continents, and the results promote increased clinical awareness that women at severe risk should be identified preoperatively...

This is a randomized, controlled, blind, crossover trial comparing cycling versus continuous programming of a sacral neuromodulator in women diagnosed with overactive bladder (OAB). At 6 months, treatment order significantly affected Overactive Bladder Questionnaire - Short Form (OABq-SF) symptom scores. The cycling followed by continuous stimulation group had superior OABq-SF scores (p > 0.02).

Men who receive bone-targeted therapy for metastatic prostate cancer are at increased risk of osteonecrosis of the jaw (ONJ). Development of ONJ has been associated with the administration of bone-targeted therapies in association with other risk factors. ONJ can be distressing for a patient because it can cause pain, risk of jaw fracture, body image disturbance, difficultly eating, and difficulty maintaining good oral hygiene. The aim of this article is to report results of an audit of prior assessment by oral and maxillofacial surgeons (OMFS) before initiation of bone-targeted therapies and whether it may reduce the risk of ONJ in patients receiving bone-targeted therapies for advanced cancers...

Urologic patients receiving bone-targeted therapies are at risk of developing osteonecrosis of the jaw (ONJ). ONJ has historically been associated with bisphosphonate therapy. More recently, RANK-Ligand inhibitors (denosumab) have also been used to reduce the risk of skeletal-related events in patients who have advanced cancers with bone metastases. More than 65% of men with metastatic prostate cancer and nearly 75% of women with metastatic breast cancer are affected by bone metastases. The literature has described ONJ associated with bisphosphonate therapy as bisphosphonate-related osteonecrosis of the jaw (BRONJ)...

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No abstract text is available yet for this article.

Due to treatment costs and lack of reimbursement, community hospitals are charged with implementing innovative strategies that will reduce the incidence of hospital-acquired catheter-associated urinary tract infections (CAUTI). A nurse-driven system for decreasing the number of hospital-acquired CAUTI is effective and useful for a community hospital. One nurse with accountability for implementing a simple evidence-based protocol can dramatically decrease the total incidence of hospital-acquired CAUTI. The basis for the success of this initiative relied heavily on the ease of using the eight-point Question the Foley criteria, the availability of the electronic medical record, interdisciplinary collaboration, and support from nursing and physician administration...