Authors (including presenting author) :
Lam YT (1), Yip LW (1), Cheng PPP (2), Wong LT (1), Li WY (1), Wong WS (1)
Affiliation :
(1) Department of Medicine, Yan Chai Hospital (2) Central Nursing Division, Yan Chai Hospital
Introduction :
Urinary retention (post-void residual urine/PVRU volumes >200mL) is one of the complications among acute stroke patients. It may lead to urinary tract infection, high blood pressure and damage brain regions which may affect stroke recovery and delay rehabilitation program. Therefore, early detection and early management of urinary retention for acute stroke patients should be promoted to enhance patients’ outcome and prevent complications.
Objectives :
(1) to develop urinary retention detection and management workflow protocol for stroke patients in Acute Stroke Unit; (2) to provide proactive urinary retention assessment to all patients in ASU; (3) to prevent urinary retention complications by early nursing interventions.
Methodology :
A workflow is implemented to assess any urinary retention symptoms and prevent its complications. Nurses start to perform post-void residual urine (PVRU) or residual urine (RU) checking by bladder scan within four hours after admission for three days in ASU. Subsequently, nurses would identify patients into three categories according to PVRU volume and provide corresponding nursing interventions.
Result & Outcome :
From January 2019 to October 2020, total 922 acute stroke patients were recruited which including 509 male patients (55%) and 413 female patients (45%). Age ranged from 19 to 104 years, mean age 74.5. 753 patients (82%) were diagnosed with ischemic stroke while 169 patients (18%) with hemorrhagic stroke. There were 415 recruited patients (45%) were detected urinary retention by workflow protocol. After providing active nursing interventions, 224 (54%) patients were significantly relieved urinary retention (p value < 0.00001). For those who got persistent urinary retention and inserted Foley catheter, 59% of them were able to wean off Foley catheter in ASU. 23% of them got urinary tract infection. There were no significant relationship between urinary retention to gender (p value=0.63), age (p value=0.56) and stroke type (p value=0.13).
