Bladder Ultrasound Technology Essay

The in work issueation conducted by Frederickson et al. was able to show the pick up to drill a vesica S trickner for the accu pasture and efficient judicial decision of vesica volume in operative business concern. The vesica dilatation that go push through be experienced by the forbearings female genital organ ca usage complications and health problems if appropriate measures go a representation non be taken. The traditional antecedent which is to insert a catheter into the urethra of the patient is no longer a viable option be seduce it developments patient pique as easily as incr peace of minds the rate of infections.The origin in that locationfore is to utilization ultrasonography engineering such as the vesica discernner that testament stainlessly and efficiently assess vesica volume. The completed assessment ordain lead to the decoctd usage of catheterization in operative c ar this pass on likewise al outset for the reduction in the ran k of infection, the exist of treating UTI, increase the qualification of the nurses. This will ease the burden of the nurses and hand them more impelling in focusing on other tasks this will withal ease the psychological and physical discomfort of the patients.The Implementation of Bedside vesica Ultrasound applied science Effects on Patient and Cost Postoperative Outcomes in third Care A Critique of the Study In postoperative care it is common to encounter the problem of urinary retention. It washbasin be verbalize that one and except(a) of the side resultant roles of drugs, especially the hire of anesthesia is bladder distention. This is characterized by the patients inability to distinguish if he or she has a full bladder and choose to empty it. bladder distention can reasonableness complications and needless to say health workers must do their best to securenessly empty the bladder.Since in that location is no way of salubrious-read if the bladder is about to be strike down or non the plebeian method of dealing with this problem is intermittent catheterization but it is an invasive map that is not only a energize for discomfort for the patient, added cost to healthcare and demands more period from the nurses. past from all these problems, catheterization can alike cause urinary tract information or UTI. in that respect is on that pointfore the need to have another alternative solution to urinary retention and distention. integrity of the most practical solutions is the use of a bladder ScanIt was indomitable that in postoperative care the effects of anesthesia and medication can cause distention. The patient loses the ability to feel that his or her bladder is already full and at that placefore realizes that it is time to empty the bladder. There is no need to elaborate on the fact that if this will continue then thither would be harmful effects on the body as the bladder is a major component of the excretory system. Witho ut the capability to void then the patient will increase the risk of developing complications. The solution was to use catheterization. This is a procedure where tubes are inserted into the urethra of the patient.This is a painful process not to credit that it can humiliate the patient especially those who are not comfortable with the procedure. Aside from that the procedure is known to be the major cause of urinary tract infections. As a foreign object is inserted into the adult male body there is an increase in the probability that microorganisms can also be introduced into the system. This is the reason why the rate of infections shoots up whenever catheterization is regularly harbour in postoperative care. Health workers created a solution to this problem and it is to apply measure intermittent catheterization. This exclusively agency that a catheter is not permanently attached to the patient but only in a bring down time. The period when it is optimal to insert a cathet er can be divided up into two. The first one is called out-of-pocket to void meaning that after a long period of time the bladder can be pass judgment to be full. The second time when catheterization is expected is called void with residual this means that the patient was able to empty the bladder but there is subdued a residual and since there is no way to root the remove volume of the residual, catheterization is required.The solution therefore is ultrasound technology. This allows for the accurate assessment of bladder volume to determine if catheterization is required or not. The Bladder Scan comes in two models the Bladder good deal Instrument BVI 2000 and BVI 2500. It uses ultrasound technology and this simply means that the device emits waves in the same way that a gunslinger uses sonar or a bat emits sound to determine the length and shape of solid objects that cannot be seen by the naked eye.Therefore, when the Bladder Scan is placed near the bladder area the mach ine can throw a three dimensional image that will allow the health care worker to assess bladder volume. If there is a way for an accurate assessment of bladder volume then the fall of catheterization can be reduced and therefore one can also reduce the rate of infections, the cost of treating UTI, and increase the productivity of nurses. 1. What is the discipline problem? sporadic catheterization is the major intervention employ to ensure that the bladder is emptied in due to void cases and in cases where there is postvoid residual and yet incomplete modify has occurred. But there is one only problem, catheterization increases the rate of UTI. It is also a waste of nurses time and effort not to mention that patients complain of psychological and physical discomfort when catheterization is used. There is therefore a need to find a way to minimize unnecessary catheterization.A bladder scan VBI 2500 will be tested for its effectiveness and efficiency in 3rd postoperative populat ions. 2. What is the study purpose? It was determined that one possible solution is to use bedside bladder ultrasound technology, specifically, the BVI 2500 Bladder Volume Instrument. In this regard the purpose of the study was to determine the effect of ultrasound assessment of bladder volume on patient and cost outcomes for patients needing postoperative catheterization. 3. Is the lit review presented?Previous studies were identified and cited as a posterior for the research. The most significant review of literature was a study do using a similar instrument. Ouslander and associates were cited as having performed an experiment using the Bladder Volume Instrument BVI 2000 and BVI 2500. The relevance of the review of literature was also seen in the discussion on the accuracy of the BVI 2000 and BVI 2500 in measuring bladder volume. It can also be seen from the discussion of the accuracy of the instrument when measuring postvoid residual.Aside from the relevance of the literature it was also ascertained that the references were current. Moreover, the origin did not only discuss what were the pertinent information that can be found in the said references but also critiqued the said studies by saying that although entrusts elevate the use of a bladder digital digital scanner but a clinical study is involve to determine its effectiveness and cost in tertiary postoperative populations. The author was able to do this by making a summary of the current knowledge provided by the references cited.As stated old part of the summary includes the discussion on the success of the bladder scanner in nursing homes and in an outpatient clinic but there is no data when it comes to its effectiveness and efficiency in tertiary postoperative settings. 4. Is a study framework identified? The study framework was identified and listed in the form of research questions ? What is the accuracy of ultrasound assessment of bladder volume? ? Does ultrasound assessment of bladd er volume result in less haunt catheterization for due to void and residual events?? Is there a difference in frequency of catheterization when bladder ultrasound assessment is used rather than shopworn catheterization procedure? ? Does ultrasound assessment of bladder volume versus standard catheterization result in decreased tract infections? ? Does ultrasound assessment of bladder impressiveness versus standard catheterization result in decreased health care cost? ? What is the patient and staff satisfaction with bladder ultrasound technology? 5. be research objectives, questions or hypotheses used to direct the conduct of the study?The said(prenominal) research objectives can be used to direct the conduct of the study. Its main(prenominal) focus is the determination of the accuracy and efficiency of the BVI 2500 bladder scanner in tertiary postoperative populations as well as to find out the satisfaction levels of patients and the nurses. 6. argon the major variable stars o r concepts identified and defined (conceptually and workally? Identify and define the appropriate variables. The variables were 1) the number of catheterizations avoided 2)infection rates 3) cost epitome of catheter acquisition and 4) patient/provider satisfaction.The dependent variable is the number of catheterizations enchantment the independent variable is the use of the bladder scanner as a tool to assess bladder fullness. other dependent variable is the rate of UTI infections, the cost analysis of catheterization equipment and the satisfaction of patient and provider. 7. What attribute or demographic variables are examined in the study? An example of a demographic variable is the age of the subjects, age and surgical procedure that they had to go through. 8. Is the research radiation diagram clearly addressed?The research jut out was clearly addressed because the author do clear from the onset that this study is about an intervention, specifically the escape of cathete rization which in turn will reduce the rate of infections. The author was also able to clarify how this can be achieved by using a bladders scanner and for the control group the use of straight timed intermittent catheterization. The subjects were not randomly assigned there was a deliberate political program to use tetrad surgical building blocks as data collection sites. From these four surgical units the pleaders of the study divided the 132 samples into two groups.The first group contains 50 samples who had urologic, colon and gynecologic surgical procedure while the second group contains 82 having total joint replacement and spine surgery. It is clear that the subjects were divided base on the type of surgeries that they went through. An explanation for this can be extracted from the review of literature wherein it says that bladder distention can be caused by anesthesia and medication. Thus, in order to minimize error it is best to group the subjects into the type of su rgery that they went through.But this type of grouping can result in the introduction of extraneous variables. For instance even though there are surgeries that assume under popular surgery such as urology and operation on the colon these two deal with different parts of the body. urogenital medicine for instance deal with the urinary tracts of males and females therefore it can have an effect on the bladder or the rate of infections in the urinary tracts of the patients. Another extraneous variable is the skill level of the nurses that were assigned to operate the bladder scanner.There were no pilot studies conducted onwardshand. All the necessary information needed for the design of the study were taken from the review of related literature. 9. Are the quest elements of the sample described? The inclusion criteria includes patients who had undergone general and orthopaedic surgery. Exclusion criteria includes patients that had epidermic ulcers, nephrotomy, obesity, confirme d pregnancy, in incision in a location that precludes ultrasound exam, or a known pelvic mass greater than 2 cm.The sampling frame includes only those who are patients in a incident vainglorious tertiary care hospital chosen by the proponents and pay off the following conditions ? they had undergone general surgery or ? they had undergone orthopaedic surgery. Based on the sample frame the sample size was determined to be 132. great power analysis was done after the experiment. The proponents wanted to find out if there age, gender and type of surgery had an effect on the test results. They were able to determine that only age and type of surgery had an impact on the test results whereas there was no significant difference when it comes to gender.With the general surgical unit all were approved but with the orthopedic surgical unit only 53 was approved and therefor the attrition rate for the orthopaedic surgical unit was 39%. Before the patients were allowed to participate in the experiment the hospitals Human Subjects Review Board had to approve the study protocol and all patients who had the stated surgeries and were due to void or void with residual assessment were screened for exclusion criteria and then approached for consent. All consenting patients on the general surgical unit were cleared to undergo ultrasound assessment of bladder volume.Those who were approved to participate from the orthopaedic surgical unit were catheterized or assessed with the ultrasound technology. The setting was appropriate for the conduct of the study because it is a large tertiary postoperative facility and that the patients under their care needed to be catheterized especially those who are due to void or void with residual. 10. Are the meters strategies described? The study used the Likert format having five anchors ranging from not quenched to very satisfied.This bar outline was developed by Rensis Likert and this was used to determine the level of satisfaction fel t by the patient as well as the provider when it comes to the usage of bladder scanner. Another measurement strategy utilized in the study was the t-test, Chi even up and Pearson correlation. The t-test and Chi Square were used to examine difference between groups while the Pearson correlation was used to examine relationships between two variables. In the Likert system the level of measurement was ordinal. While the rest of the measurement strategies that were used in the study, the level of measurement was a ratio.The measurement strategies used in this study were all steady-going especially when it was reinforced by the use of the statistical Package for the fond Sciences a computer program that allows for quick but accurate computations. In the previous study or the experiment described in the literature review, the proponents used Test-Retest Reliability measurement. This measurement strategy is not as trustworthy as the measurement strategies used in the current study. It is simply a retesting of the same subjects but at a different time period.If the design of the experiment was flawed to begin with the Test-Retest Reliability measurement will not be able to determine this type of error. 11. How were study procedures implemented and regard collected during the study? The study procedures were implemented using standard timed intermittent catheterization protocol as well as ultrasound protocols. In the former there was a strict schedule to be followed and in the latter bladder scanners were used to assess bladder volume and from there make a decision to catheterize the patient or abstain from doing so. 12.What statistical analyses are included in the research report? The Statistical Package fro the Social Sciences was used for analysis and an alpha level of 0. 5 was chosen as a level of significance. 13. What is the detectives reading of the findings? The investigator was pleased with the findings. Aside from the fact that the proponent was ver y overconfident of the reliability and accuracy of the data, the result also closely resembled the results of previous studies as seen in the literature review. 14. Are the limitations of the study identified by the researcher?The researchers were able to point out the limitations of the study. First of all there was a problem with the sampling. The sample size was very small and because of this predicament the proponent of the stud was unable to make random selection of patients. For instance there were 50 patients in the general surgical unit and everyone were included in the experiment. There were also other factors that needed to be tested such as the type of surgeries that the subjects went through were varied especially in the general surgery group. 15.What conclusions did the researcher identify based on this study and previous research? The proponent of the study was able to determine that ultrasound technology is an accurate and efficient way to assess bladder volume. But they were also able to ascertain that it would be better if a portable scanner will be used instead of a bigger and bulkier machine. 16. How does the researcher conclude the findings? The researcher made the generalization that the Bladder scanner is accurate and efficient. This is based on the results that say it was able to detect even low levels of urine in the void with residual category.Researchers were also able to generalize that patient and provider were both highly satisfied with the use of the Bladder Scanner. 17. What implications do the findings have for nursing practice? This device can by all odds help health workers to maximize their time and be more efficient. regular timed intermittent catheterization requires for the insertion of a catheter on a regular basis and this will easily consume their time as well as increase the discomfort of the patients. 18. What suggestions are made for further studies? There is a need to look into the age difference of the subjects .The researcher pointed out that age is a demographic factor that is significantly related to number of catheterizations required. In future studies there is a need to have a larger sample to so that the age of the subjects can be varied. 19. What are the missing elements of the study? One missing element is that there was no discussion regarding the warranty of the device. There was a generalization that it is cost-efficient to use the Bladder Scanner because it reduced the number of catheterization, the rates of infection and reduces the time needed for nurses to take care of UTI and intermittent catheterizations.But there was no discussion regarding the ability of the Bladder Scanner to withstand repeated abuse. It was made clear that it would take 2. 9 years of continuous usage before one can recover the investment on the Bladder Scanner, there is a need to know if it is sturdy enough to last beyond a three-year period. 20. Is the description of the study sufficiently clear to a llow for riposte? The description of the study is sufficiently clear to allow for replication. The protocols that were established forward is a major reason why this study can be replicated.The study conducted by Frederickson et al. was able to show the need for a Bladder Scanner or similar device in postoperative care. The bladder distention that will be experienced by the patients can cause complications and health problems if appropriate measures will not be taken. The traditional solution which is to insert a catheter into the urethra of the patient is no longer a viable option because it increases patient discomfort as well as increases the rate of infections.The innovate solution of using standard time intermittent catheterization is not a very good solution because it still cannot eliminate the problems discussed before although it can slightly reduce the total amount of time that catheterization is used. The solution therefore is to use ultrasound technology such as the B ladder Scanner that will accurately and efficiently assess bladder volume. The accurate assessment will lead to the reduced usage of catheterization in postoperative care this will also allow for the reduction in the rates of infection, the cost of treating UTI, increase the efficiency of the nurses.This will ease the burden of the nurses and make them more effective in focusing on other tasks this will also ease the psychological and physical discomfort of the patients. References Frederickson, M. et al. The Implementation of Bedside Bladder Ultrasound Technology Effects on Patient and Cost postoperative Outcomes in Tertiary Care. Orthopaedic Nursing. 19(3) 79-87. Warner, A. J. et al. Postoperative Bladder Distention mensuration with Bladder Ultrasonograph. Journal of Perianesthesia Nursing 15(1) 20-5.