1. Self Catheterization PACT
Jeffrey Despommier, OTR, MOT; Gisela Sanchez-Williams, R.N., M.S.N., ANP-C; Shelby Ubrich, OTR, MOT; Michelle Kennedy, RN, CCRP; Amy Ng, M.D. S
Introduction
Oncology patients in acute inpatient rehabilitation present with multiple diagnoses that can impact the ability to empty the bladder volitionally. For patients with neurogenic bladder, the gold standard is to perform intermittent catheterization to empty the bladder. Although there are many studies that support different types and styles of catheters, there is a paucity of research on intermittent catheterization within the oncology population. A professional action coordinating team (PACT) was created to help determine which type of catheter is best for oncology patients and to update the educational videos to align with the new catheter guidelines implemented in The self-catheterization PACT members include occupational therapists, advanced practice nursing, a physiatrist, inpatient, ambulatory and research nursing.
Progress
The PACT has received approval from the Quality Improvement Assessment Board (QIAB) to complete a study comparing intermittent catheters with oncology patients.
The PACT has met with the University of Texas Television department to discuss ideas for rendering new videos that will be unique to the oncology setting. Upon receiving funding, the PACT will proceed with creating new videos for the Patient Education Center.
Purpose
The purpose of the PACT is threefold:
1) To determine what type of catheter is preferred with oncology patients who have neurogenic bladder.
2) To improve the options of catheters that are available to patients and nurses at MD Anderson.
3) To create new patient educational videos on intermittent catheterization that reflect the new guidelines implemented in 2008 which recommend single use catheters instead of washing and reusing catheters.
Methods
Three different catheters were chosen for the study: an uncoated red rubber catheter, a hydrophilic catheter with a sleeve, and a hydrophilic catheter without a sleeve.
Each patient/caregiver will receive a 1:1 training session on intermittent catheterization prior to participating in the study.
A survey consisting of 8 questions will be administered after each catheterization measuring patient and/or caregivers’ satisfaction with the catheter.
After 30 patients have participated in the study, data from the survey will be analyzed and presented to the Value Analysis Team (VAT) to determine which catheter(s) to consider carrying at MD Anderson.
References
Prieto, J., C. L. Murphy, et al. (2014). "Intermittent catheterisation for long-term bladder management." Cochrane Database of Systematic Reviews 9: CD
Leek, H., Z. Stephenson, et al. (2013). "Clean intermittent self-catheterisation: A randomised controlled crossover trial of single-use versus multiple re-use of non-coated catheters; is cystitis rate altered?" Neurourology and Urodynamics 32 (6):
Bermingham, S. L., S. Hodgkinson, et al. (2013). "Intermittent self catheterisation with hydrophilic, gel reservoir, and non-coated catheters: a systematic review and cost effectiveness analysis." BMJ 346: e8639.
Moore, K. N., M. Fader, et al. (2007). "Long-term bladder management by intermittent catheterisation in adults and children." Cochrane Database of Systematic Reviews(4): CD
Wong-Baker FACES® Pain Rating Scale: printed and used with permission