1. Cinny Cusack Physiotherapy Manager Mary O’ Reilly Practice Development
Improving patient safety by early recognition and intervention for urinary retention in the Rotunda Hospital
Cinny Cusack Physiotherapy Manager
Mary O’ Reilly Practice Development

2. Q.I.P using PDSA cycle to reduce short and long term complications of urinary retention (UR)
Clinical audit on management of UR 2012
Findings were inconsistency in diagnosis and management
Patients with long term bladder issues requiring ongoing physio
MDT workshops
Education on UR, feedback on clinical issues
Bladder care packs introduced on wards
2013 bladder care guidelines updated
Further staff education sessions to embed clinical changes
Measuring first 2 voids post delivery/surgery
Patient empowerment by introducing patient fluid balance chart
Re audit completed July 2014
Presentation of findings at Grand rounds, National patient safety conference 2015, Poster at ISCP conference

3. Project Outcomes
Pain and constipation identified as risk factors with improved management.
Prevention of delayed discharge due to indwelling catheter
Improved post natal patient pathway by follow up in OPD
Improved staff awareness of risks of developing UR and long term consequences
Improved management though updated clinical guidelines and embedded changes in clinical practice
Measuring first 2 voids
Use of patient FV charts
Changes in catheter management
Introduction of self intermittent catheterisation
Completed re audit over 6 months Jan to July 2014
Reduction in symptom severity and number of UR cases
2014 N= 62
2015 N= 47

4. Main Learning from Project
Good team work and collaboration vital
Education is key for both staff and patients
Accurate documentation is vital
Staff attitudes could be challenging- need staff buy in to change practice
Practicalities and cost
Following the removal of your catheter, try and empty your bladder every 2-3 hours or sooner if you feel the urge to go.
Drink 2 litres of fluid slowly during the day. (3 litres if you are breastfeeding)
Record the amount of urine passed and fluid taken.
FLUID INTAKE CUP/GLASS
URINE OUT IN MLS
RESIDUAL VOLUME
RECORD ANY SENSATION OF URGE OR BLADDER PAIN BEFORE VOIDING
6 am
7 am
8 am
9 am
10 am
11 am
12 noon
1 pm
2 pm
3 pm
4 pm
5 pm
6 pm
7 pm
8 pm
9 pm
10 pm
11 pm
12 pm
2 -3 am
4 -5 am
Total